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自制简易脑立体定向仪辅助神经内镜治疗基底节区 脑出血的疗效分析
吴良发  谢英彬  唐宽宇  邵先矛  孙军  毛小满  颜伟  
0
()
摘要:
目的 探讨自制简易脑立体定向仪辅助神经内镜治疗基底节区脑出血的疗效。方法 回 顾性收集 2019 年 1 月至 2020 年 12 月南京市浦口区中心医院收治的 40 例高血压基底节区脑出血患者的 手术资料,按手术方式分为观察组(22 例)和对照组(18 例),观察组采用简易脑立体定向仪辅助内镜下血 肿清除术,对照组采用常规骨瓣开颅血肿清除术。比较两组患者术前一般资料、手术时间、术中出血量、 血肿清除率、术后并发症发生率,采用扩展格拉斯哥预后评分(GOS-E)比较两组患者术后 3 个月 GOS-E 良好率。结果 观察组手术时间短于对照组[(65.8±10.5)min 比(125.3±20.4)min]、术中出血量少于 对照组[(50.2±10.6)ml 比(295.3±18.5)ml]、血肿清除率高于对照组[(88.2±3.8)% 比(70.3±5.6)%],差 异均有统计学意义(均P< 0.05)。观察组患者术后 3 个月 GOS-E 良好率为 72.7%(16/22),高于对照组的 7/18,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率为13.6%(3/22),与对照组的3/18比较, 差异无统计学意义(P> 0.05)。结论 相较于常规开颅血肿清除术,自制简易脑立体定向仪辅助神经内 镜治疗高血压基底节区脑出血的手术,能缩短手术时间,术中出血量少,血肿清除率高,能够改善患者 近期预后。
关键词:  高血压  脑出血  基底节区  神经内镜  立体定向仪  疗效
DOI:10.3969/j.issn.1009-6574.2022.06.011
基金项目:浦口区2018年社会事业科技项目(s2018-09);江苏卫生健康学院院级科研项目(JKC201961、 JKC202017)
Effect analysis of self-made simple stereotactic instrument assisted neuroendoscopy in the treatment of basal ganglia cerebral hemorrhage
Wu Liangfa,Xie Yingbin,Tang Kuanyu,Shao Xianmao,Sun Jun,Mao Xiaoman,Yan Wei
()
Abstract:
Objective To investigate the effect of self-made simple stereotactic instrument assisted neuroendoscopy in the treatment of basal ganglia cerebral hemorrhage. Methods The surgical data of 40 patients with hypertensive cerebral hemorrhage in the basal ganglia area from January 2019 to December 2020 in the Pukou District Central Hospital of Nanjing were collected retrospectively. According to different surgical methods, they were divided into observation group (22 cases) and control group (18 cases). Patients in the observation group underwent endoscopic simple brain stereotactic instrument to remove the hematoma; the control group underwent conventional bone flap craniotomy to remove the hematoma. The preoperative baseline data, operation time, intraoperative blood loss, hematoma clearance rate, and postoperative complications of the two groups were compared. Glasgow Outcome Scale-Extended (GOS-E) was used to compare the rate of good GOS-E scores of the two groups. Results The operation time of the observation group was shorter than that of the control group [(65.8±10.5) min vs (125.3±20.4) min]; blood loss of the observation group was less than that of the control group [(50.2±10.6) ml vs (295.3±18.5) ml]; The clearance rate of hematoma of the observation group was higher than that of the control group [(88.2±3.8)% vs (70.3±5.6)%]; The differences were statistically significant (All P< 0.01). The rate of good GOS-E score at 3 months after operation was higher than that of the control group [72.7% (16/22) vs 7/18], and the difference was statistically significant (P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups [13.6%(3/22) vs 3/18;P> 0.05]. Conclusions Compared with conventional craniotomy for hematoma removal, simple brain stereotactic instrument assisted neuroendoscopy for the treatment of hypertensive basal ganglia cerebral hemorrhage has the advantages such as shortening the operation time, less intraoperative bleeding, high hematoma removal rate, and improving the patient's short-term prognosis.
Key words:  Hypertension  Cerebral hemorrhage  Basal ganglia area  Neuroendoscopy  Stereo tactic instrument  Clinical effect

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