神经内镜与钻孔引流手术治疗高血压脑出血疗效比较

发布时间：2018-06-30 19:06

本文选题：神经内镜 + 钻孔引流　；参考：《内蒙古大学》2017年硕士论文

【摘要】：近年来,大多数高血压脑出血患者采用微创手术治疗后取得了良好的效果,但临床上对于不同微创手术术式之间的优劣进行统计学分析比较的报道较少[1]。本文收集巴彦淖尔市医院神经外科2014年3月—2016年3月收治的65例高血压脑出血手术患者病例,随机分为神经内镜手术组和钻孔引流手术组,对两种术式治疗脑出血的优缺点进行了比较,为脑出血患者选择更好的微创手术方式提供依据。主要结果如下:(1)患者性别、年龄、入院GCS评分及术前血肿量均无统计学意义,保证了患者入组的随机性。(2)在术后残余血肿量及血肿清除率方面,两个手术组具有明显的统计学意义(P0.001),内镜组具有明显优势。(3)在术后并发症方面,内镜组的肺部感染发生率明显低于钻孔组(P=0.0220.05)。而术后再出血、颅内感染、消化道出血、电解质紊乱、脑积水等并发症的发生率,两种手术方式的差异不明显(P0.05)。(4)在出血后水肿持续时间方面,内镜组的水肿持续时间比钻孔组短(P0.001),更加有利于患者术后恢复。(5)在术后6个月患者恢复方面,内镜组优于钻孔组,具有统计学意义(P0.05)。神经内镜辅助下清除脑内血肿技术,具有微创、直视、高效等优点,大大提高了血肿的即时清除率,减少了术后合并症,降低了致残率,改善了患者的预后,有望成为外科治疗高血压脑出血的首选术式。
[Abstract]:In recent years, most patients with hypertensive intracerebral hemorrhage have achieved good results after minimally invasive surgery, but there are few reports on the statistical analysis and comparison between different minimally invasive surgical procedures [1]. From March 2014 to March 2016, 65 patients with hypertensive intracerebral hemorrhage were randomly divided into two groups: endoscopic surgery group and borehole drainage group. The advantages and disadvantages of the two methods in the treatment of intracerebral hemorrhage were compared in order to provide evidence for better minimally invasive operation in patients with intracerebral hemorrhage. The main results were as follows: (1) gender, age, admission GCS score and preoperative hematoma volume were not statistically significant, which ensured the randomness of the patients entering the group. (2) the residual hematoma volume and hematoma clearance rate after operation were not statistically significant. The incidence of pulmonary infection in the endoscopic group was significantly lower than that in the borehole group (P0.0220.05). However, the incidence of postoperative rebleeding, intracranial infection, gastrointestinal bleeding, electrolyte disturbance, hydrocephalus and other complications were not significantly different (P0.05). (4). The duration of edema in the endoscopic group was shorter than that in the drilling group (P0.001), which was more conducive to postoperative recovery. (5) the endoscopic group was better than the borehole group in the recovery of patients 6 months after operation (P0.05). The technique of endoscope assisted intracerebral hematoma removal has the advantages of minimally invasive, direct vision and high efficiency. It greatly improves the immediate clearance rate of hematoma, reduces postoperative complications, reduces the rate of disability and improves the prognosis of the patients. It is expected to be the first choice for surgical treatment of hypertensive intracerebral hemorrhage.
【学位授予单位】：内蒙古大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.12

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