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投稿时间：2022-10-21 网络发布日期：2023-08-20
投稿时间：2022-10-21 网络发布日期：2023-08-20
中文摘要: 目的分析高血压脑出血（HICH）患者行神经内镜微侵袭手术的临床疗效及影响预后的因素。方法选取2020年1月至2021年12月邯郸市第一医院收治的HICH患者100例,随机分为对照组（n=50）和观察组（n=50）。对照组行小骨窗开颅血肿清除术,观察组行神经内镜微侵袭手术。比较两组血肿清除情况、美国国立卫生院卒中量表（NIHSS）和日常生活活动能力（ADL）、预后结局。根据预后将观察组分为预后良好亚组（n=37）和预后不良亚组（n=13）,对影响预后的因素进行分析。结果观察组术中出血量、术后残余血肿量均少于对照组,血肿清除率高于对照组（P＜0.05）。术后1个月,观察组预后良好率高于对照组（74.00%vs48.00%, χ2=7.104, P＜0.05）。观察组预后良好亚组术前MAP［(122.57±7.88)mmHgvs(130.26±8.97) mmHg，t=2.921, P<0.05 ］、血肿量［(39.51±3.65)mLvs(45.06±3.14) mL, t=4.877, P<0.05］、NIHSS评分［（15.63±1.23）分 vs（18.64±1.25）分，t=2.921, P<0.05］均低于预后不良亚组,术前GCS评分高于预后不良亚组［（10.84±2.39）分 vs（8.41±2.26）分，t=3.196, P<0.05］。结论神经内镜微侵袭手术治疗HICH患者有助于血肿清除、神经功能恢复,进而改善预后。术前MAP、血肿量、GCS、NIHSS与预后有关。
Abstract:ObjectiveTo analyze the clinical efficacy and prognostic influencing factors of neuro-endoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage （HICH）. MethodsA total of 100 patients with HICH admitted to Handan First Hospital from January 2020 to December 2021 were randomly divided into control group （n=50） and observation group （n=50）. The control group underwent small bone window craniotomy for hematoma debridement, and the observation group underwent neuro-endoscopic minimally invasive surgery. The hematoma clearance, National Institutes of Health Stroke Scale （NIHSS）, Activity of Daily Living (ADL) and prognosis were compared between two groups. According to the prognosis, patients in observation group were divided into good prognosis sub-group （n=37） and poor prognosis sub-group （n=13）, and the influencing factors were analyzed. ResultsThe intraoperative blood loss and postoperative residual hematoma in observation group were less than those in control group, and the hematoma clearance rate was higher than that in control group （P＜0.05）. One month after operation, the good prognosis rate of observation group was higher than that of control group （74.00%vs48.00%, χ2=7.104, P＜0.05）. The preoperative MAP ［(122.57±7.88) mmHgvs(130.26±8.97) mmHg, t=2.921, P<0.05］, hematoma volume ［(39.51±3.65) mLvs(45.06±3.14) mL, t=4.877, P<0.05］, NIHSS score ［(15.63±1.23) vs (18.64±1.25), t=2.921, P<0.05］ of the good prognosis subgroup were all lower than those of the poor prognosis subgroup, and preoperative GCS score was higher than that of the poor prognosis subgroup ［(10.84±2.39)vs(8.41±2.26), t=3.196, P<0.05］. ConclusionNeuro-endoscopic minimally invasive surgery for HICH patients can help to clear hematoma, restore nerve function and improve prognosis. And preoperative MAP, hematoma volume, GCS, and NIHSS are associated with prognosis.
keywords: Hypertensive intracerebral hemorrhage Neuro-endoscopy Minimally invasive surgery Mean arterial pressure Hematoma volume Glasgow coma score
文章编号： 中图分类号：R743 文献标志码：A
基金项目:河北省医学科学研究课题（20200186）
| 作者 | 单位 |
| 裴献光1 | 1. 邯郸市第一医院神经外一科，河北 邯郸 056002； |
| 高芳2 | 2. 邯郸市第一医院外三科，河北 邯郸 056002； |
| 许亚宁1 | 1. 邯郸市第一医院神经外一科，河北 邯郸 056002； |
| 王志强1 | 1. 邯郸市第一医院神经外一科，河北 邯郸 056002； |
| 魏海亮1 | 1. 邯郸市第一医院神经外一科，河北 邯郸 056002 |
| Author Name | Affiliation |
| PEI Xianguang*, GAO Fang, XU Yaning, WANG Zhiqiang, WEI Hailiang | *First Department of Neurosurgery, Handan First Hospital, Handan, Hebei 056002, China |
引用文本：
裴献光,高芳,许亚宁,等.神经内镜微侵袭手术在高血压脑出血中的临床疗效及预后[J].中国临床研究,2023,36(8):1157-1161.
裴献光,高芳,许亚宁,等.神经内镜微侵袭手术在高血压脑出血中的临床疗效及预后[J].中国临床研究,2023,36(8):1157-1161.