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内镜下颅内血肿清除术与血肿穿刺引流术治疗高血压性脑出血的疗效及预后

Effect and prognosis of endoscopic intracranial hematoma removal and hematoma puncture and drainage in patients with hypertensive intracerebral hemorrhage.

作者信息

Xia Yi, Wang Renping

机构信息

Department of Neurosurgery, Qixingguan District People's Hospital, Bijie, Guizhou Province, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2024 Jun;19(2):266-273. doi: 10.5114/wiitm.2024.140613. Epub 2024 Jun 13.

Abstract

INTRODUCTION

Hypertensive intracerebral hemorrhage is one of the most serious complications of hypertension. The treatment focuses on reducing bleeding damage and promoting functional recovery.

AIM

This study investigated the efficacy and prognosis of endoscopic intracranial hematoma removal (EIHR) and hematoma puncture and drainage (HPD) in treating hypertensive intracerebral hemorrhage (HICH).

MATERIAL AND METHODS

Ninety-two patients admitted to our hospital for EIHR and HPD between September 30, 2021 and September 30, 2022 were enrolled, including 14 cases of EIHR (endoscopy group) and 78 cases of HPD (puncture group). The efficacy of the two surgery modes in treating HICH patients was compared. Univariate logistic regression (ULR) and multivariate logistic regression (MLR) were employed to analyze the influences of different treatment methods on the prognosis of patients with HICH.

RESULTS

The average hematoma clearance rate (HCR) of all patients was 80.52%, and the patients in the endoscopy group had a higher HCR than those in the puncture group (73.00% vs. 86.00%) (p < 0.001). The good prognosis rate (GPR) shown by the Glasgow Outcome Scale (GOS) score in the endoscopy group was 69.23%, and that in the puncture group was 40.38%, a large but statistically non-significant difference (p > 0.05).

CONCLUSIONS

The HCR of EIHR was greatly higher based on that of HPD, but showed no great difference in prognostic effect. The higher the GCS score on admission, the lower the likelihood of poor prognosis.

摘要

引言

高血压性脑出血是高血压最严重的并发症之一。治疗重点在于减少出血损伤并促进功能恢复。

目的

本研究探讨了内镜下颅内血肿清除术(EIHR)和血肿穿刺引流术(HPD)治疗高血压性脑出血(HICH)的疗效及预后。

材料与方法

选取2021年9月30日至2022年9月30日在我院接受EIHR和HPD治疗的92例患者,其中EIHR组14例(内镜组),HPD组78例(穿刺组)。比较两种手术方式治疗HICH患者的疗效。采用单因素逻辑回归(ULR)和多因素逻辑回归(MLR)分析不同治疗方法对HICH患者预后的影响。

结果

所有患者的平均血肿清除率(HCR)为80.52%,内镜组患者的HCR高于穿刺组(73.00%对86.00%)(p<0.001)。内镜组格拉斯哥预后量表(GOS)评分显示的良好预后率(GPR)为69.23%,穿刺组为40.38%,差异较大但无统计学意义(p>0.05)。

结论

EIHR的HCR显著高于HPD,但在预后效果上无显著差异。入院时GCS评分越高,预后不良可能性越低。

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