神经导航辅助内镜与显微下开颅手术治疗基底节区高血压脑出血的疗效对比

发布时间：2018-11-25 06:53

【摘要】：目的:研究分析对比神经导航辅助内镜与显微镜下开颅手术治疗高血压脑出血疗效;探讨其临床应用及价值。方法:收集自2012年1月-2016年11月应用神经导航辅助内镜手术治疗的患者,随机抽取30例为导航内镜组;收集开颅手术治疗高血压脑出血的患者,随机抽取30例为显微开颅组。采用相同的纳入和排除标准。记录两组患者术后GCS评分,皮肤切口长度、手术时间、手术出血量、住院时间、术后并发症及术后随访第6个月KPS评分进行比较分析。结果:导航内镜组与显微开颅组相比,术后GCS昏迷评分两组差异无统计学意义(P0.05);在皮肤切口上,导航内镜组平均切口长度为(4.22±0.43)cm,显微开颅组平均切口长度为(13.23±1.00)cm,两组差异有统计学意义(P0.05);在手术时间上,导航内镜组平均手术时间为(90.27±14.31)min,显微开颅组的平均手术时间为(186.50±26.62)min,两组差异有统计学意义(P0.05);在手术出血量上,导航内镜组平均出血量为(74.33±22.23)ml,显微开颅组平均出血量为(194.33±35.40)ml,两组对比差异有统计学意义(P0.05);在住院天数上,导航内镜组平均住院天数为(12.40±2.28)d,显微开颅组的平均住院天数为(15.87±2.42)d,两组对比差异有统计学意义(P0.05);在并发症上,导航内镜组发病率明显低于显微开颅组,两组对比差异有统计学意义(P0.05);术后随访6个月KPS评分导航内镜组预后优于显微开颅组,两组对比差异有统计学意义(P0.05)。结论:神经导航辅助内镜治疗高血压脑出血定位准确、微创、直视、省时、止血充分,出血量少、缩短住院天数、降低并发症发病率,术后生活质量较好;其应用前景广阔、在临床方面值得推广。
[Abstract]:Objective: to study and compare the therapeutic effects of neuronavigation assisted endoscopy and microscopical craniotomy on hypertensive intracerebral hemorrhage (hypertensive intracerebral hemorrhage), and to explore its clinical application and value. Methods: from January 2012 to November 2016, 30 patients with hypertensive intracerebral hemorrhage were randomly selected as navigation endoscopy group and 30 patients were randomly selected as microcraniotomy group. Apply the same inclusion and exclusion criteria. The GCS score, incision length, operation time, blood loss, hospital stay, postoperative complications and KPS score were compared between the two groups. Results: there was no significant difference in GCS coma score between the navigation endoscopy group and the microcraniotomy group (P0.05). In the skin incision, the average incision length of the navigation endoscope group was (4.22 卤0.43) cm, microcraniotomy group was (13.23 卤1.00) cm, there was significant difference between the two groups (P0.05). In the operation time, the mean operation time of the navigation endoscope group was (90.27 卤14.31) min, microcraniotomy group was (186.50 卤26.62) min, there was significant difference between the two groups (P0.05). The mean amount of blood loss in the navigation endoscopy group was (74.33 卤22.23) ml, microcraniotomy group was (194.33 卤35.40) ml, there was significant difference between the two groups (P0.05). The average hospitalization days were (12.40 卤2.28) days in the navigation endoscopy group and (15.87 卤2.42) days in the microcraniotomy group. The difference between the two groups was statistically significant (P0.05). In the complications, the incidence of navigation endoscopic group was significantly lower than that of microcraniotomy group, the difference between the two groups was statistically significant (P0.05). The prognosis of the endoscopic group was better than that of the microcraniotomy group after 6 months follow-up with KPS score. The difference between the two groups was statistically significant (P0.05). Conclusion: neuronavigation assisted endoscopy in the treatment of hypertensive intracerebral hemorrhage is accurate, minimally invasive, direct vision, time-saving, sufficient hemostasis, less bleeding, shorter hospitalization days, lower incidence of complications and better quality of life after operation. Its application prospect is broad, in the clinical aspect is worth popularizing.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.1

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