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神经内镜辅助与小骨窗开颅术治疗高血压性脑出血的回顾性分析。

Neuroendoscopic-assisted versus mini-open craniotomy for hypertensive intracerebral hemorrhage: a retrospective analysis.

机构信息

Department of Neurosurgery, The Xi'an Daxing Hospital, Xi'an, Shaanxi, China.

Department of Neurosurgery, The Xi'an Fengcheng Hospital, No.9 Fengcheng Third Road, Xi'an Economic and Technological Development Zone, Xi'an, Shaanxi, China.

出版信息

BMC Surg. 2022 May 14;22(1):188. doi: 10.1186/s12893-022-01642-8.

Abstract

OBJECTIVE

To compare outcomes in neuroendoscopic-assisted vs mini-open craniotomy for hypertensive intracerebral hemorrhage (HICH), so as to provide reasonable surgical treatment.

METHODS

Clinical data of 184 patients with HICH in the hospital from January 2019 to May 2021 were analyzed retrospectively. The patients were divided into mini-open craniotomy group and neuroendoscopic-assisted group. The operation time, hematoma clearance rate, intraoperative blood loss, neurological function recovery, and postoperative mortality of the two groups were compared by retrospective analysis.

RESULTS

The operation time and intraoperative blood loss in the mini-open craniotomy group were more than those in the neuroendoscopic-assisted group, but there was no significant difference between the two groups. There was no significant difference in hematoma clearance rate between the two groups, but for the rugby hematoma, the hematoma clearance rate in the neuroendoscopic-assisted group was higher than in the mini-open craniotomy group, the difference was statistically significant. Within 1 month after the operation, there was no significant difference in mortality between the two groups. 6 months after the operation, there was no significant difference in the recovery of neurological function between the two groups.

CONCLUSION

Neuroendoscopic-assisted and mini-open craniotomy for the treatment of HICH has the advantages of minimal trauma with good effects, and its main reason for short operation time, reduced bleeding, and high hematoma clearance rate. Although the two surgical methods can improve the survival rate of patients, they do not change the prognosis of patients. Therefore, the choice of surgical methods should be adopted based on the patient's clinical manifestations, hematoma volume, hematoma type, and the experience of the surgeon.

摘要

目的

比较神经内镜辅助与小骨窗开颅术治疗高血压性脑出血(HICH)的效果,为临床提供合理的手术治疗方案。

方法

回顾性分析 2019 年 1 月至 2021 年 5 月医院收治的 184 例 HICH 患者的临床资料,根据手术方法不同分为小骨窗开颅组和神经内镜辅助组,比较两组患者的手术时间、血肿清除率、术中出血量、神经功能恢复情况及术后病死率。

结果

小骨窗开颅组的手术时间和术中出血量均多于神经内镜辅助组,但差异无统计学意义。两组患者的血肿清除率比较,差异无统计学意义;但对于橄榄球形血肿,神经内镜辅助组的血肿清除率高于小骨窗开颅组,差异有统计学意义。术后 1 个月内,两组病死率比较,差异无统计学意义。术后 6 个月,两组患者的神经功能恢复情况比较,差异无统计学意义。

结论

神经内镜辅助与小骨窗开颅术治疗 HICH 均具有创伤小、效果好的优点,其主要原因为手术时间短、术中出血量少、血肿清除率高。虽然两种手术方法均能提高患者的生存率,但对患者预后无明显影响。因此,手术方法的选择应根据患者的临床表现、血肿量、血肿类型及术者经验来决定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d88/9107718/3b6965147a06/12893_2022_1642_Fig1_HTML.jpg

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