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神经内镜辅助手术治疗慢性硬膜下血肿的疗效及预后

Efficacy and prognosis of neuroendoscopy-assisted surgery for chronic subdural hematoma.

作者信息

Ma Baolin, Song Huping, Lin Wuyong

机构信息

Baolin Ma, Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, 361022, China.

Huping Song, Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, 361022, China.

出版信息

Pak J Med Sci. 2023 Mar-Apr;39(2):578-582. doi: 10.12669/pjms.39.2.6642.

Abstract

OBJECTIVE

This paper aims to analyze the clinical effect and prognosis of neuroendoscopy-assisted surgery for chronic subdural hematoma (CSDH).

METHODS

The clinical data of CSDH patients who underwent surgery between March 2018 and June 2020 in the Department of Neurosurgery of the First Affiliated Hospital of Xiamen University were retrospectively collected and analyzed. Eighty patients with CSDH who met the inclusive criteria were selected. A control group (32 cases treated with burr hole drainage) and an observation group (48 cases treated with neuroendoscopy-assisted surgery) were set according to different operation methods. The hematoma clearance rate, surgery-related indicators, related complications, hematoma recurrence rate and related prognostic indicators of the two groups were compared and analyzed.

RESULT

The postoperative hematoma clearance rate of the observation group was 92.59%, which was higher than that of the control group (77.78%) (P<0.05). The operation time of the observation group was longer than that of the control group (P<0.05). The postoperative hospitalization time of the observation group was shorter than that of the control group (P<0.05). The postoperative complication rate of the observation group was lower than that of the control group (P<0.05). The recurrence rate of hematoma in the observation group in the six-month postoperative follow-up was 1.85%, which was lower than that in the control group (P<0.05). The limb motor function and daily living ability score of the observation group were higher than those of the control group, and the Markwalder grading score was lower than that of the control group (P<0.05).

CONCLUSION

Neuroendoscopy-assisted treatment which is safe and effective is superior to traditional burr-hole drainage surgery. It can reduce the recurrence rate; thus, it is worth advocating and applying.

摘要

目的

本文旨在分析神经内镜辅助手术治疗慢性硬膜下血肿(CSDH)的临床效果及预后。

方法

回顾性收集并分析2018年3月至2020年6月在厦门大学附属第一医院神经外科接受手术的CSDH患者的临床资料。选取80例符合纳入标准的CSDH患者。根据不同手术方式分为对照组(32例行钻孔引流术)和观察组(48例行神经内镜辅助手术)。比较分析两组的血肿清除率、手术相关指标、相关并发症、血肿复发率及相关预后指标。

结果

观察组术后血肿清除率为92.59%,高于对照组的77.78%(P<0.05)。观察组手术时间长于对照组(P<0.05)。观察组术后住院时间短于对照组(P<0.05)。观察组术后并发症发生率低于对照组(P<0.05)。观察组术后6个月随访血肿复发率为1.85%,低于对照组(P<0.05)。观察组肢体运动功能及日常生活能力评分高于对照组,Markwalder分级评分低于对照组(P<0.05)。

结论

神经内镜辅助治疗安全有效,优于传统钻孔引流手术,可降低复发率,值得推广应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/10025695/1647ad041f50/PJMS-39-578-g001.jpg

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