组织扩张器辅助神经内镜治疗高血压脑出血的临床应用价值分析

目的:探讨组织扩张器辅助神经内镜治疗高血压脑出血的临床效果,为高血压脑出血的治疗提供依据。方法:选择我院2017年2月至2018年1月收治的高血压脑出血患者108例,其中应用组织扩张器辅助神经内镜治疗的高血压脑出血患者52例作为研究组,应用传统开颅血肿清除术治疗的高血压脑出血患者56例作为对照组。比较两组手术出血量、血肿清除率、手术时间、术后再出血率、术后并发症发生情况及术后3个月、术后6个月格拉斯哥预后评分(GOS)情况。结果:研究组手术时间短于对照组,研究组手术出血量、术后再出血率均低于对照组,血肿清除率高于对照组(P0.05)。研究组肺部感染、尿路感染发生率低于对照组(P0.05);两组消化道出血、深静脉血栓发生率比较差异无统计学意义(P0.05)。两组术后6个月GOS评分分布优于术后3个月,术后3个月、术后6个月研究组GOS评分分布优于对照组(P0.05)。结论:组织扩张器辅助神经内镜治疗高血压脑出血能有效缩短手术时间和减少术中出血量,其血肿清除率也更高,且患者术后并发症发生率较低,预后较好。

Clinical Value of Tissue Expander Assisted Neuroendoscopy for Hypertensive Intracerebral Hemorrhage

ABSTRACT Objective: To explore the clinical effect of tissue expander assisted neuroendoscopy in the treatment of hypertensive intracerebral hemorrhage, and to provide evidence for the treatment of hypertensive intracerebral hemorrhage. Methods: 108 patients with hypertensive intracerebral hemorrhage who were treated in our hospital from February 2017 to January 2018 were selected. Among them,52 patients with hypertensive intracerebral hemorrhage treated with tissue expander assisted neuroendoscopy were selected as the study group. 56 patients with hypertensive intracerebral hemorrhage treated by traditional craniotomy and evacuation of hematoma were used as the control group. The bleeding volume, hematoma clearance rate, operation time, postoperative rebleeding rate, postoperative compli- cations and Glasgow outcome score (GOS) at 3 months after operation and 6 months after operation were compared between the two groups. Results: The operation time of the study group was shorter than that of the control group. The bleeding volume and rebleeding rate of the study group were lower than those of the control group, and the hematoma clearance rate was higher than that of the control group, the difference was statistically significant (P<0.05). The incidence of pulmonary infection and urinary tract infection in the study group were significantly lower than those in the control group (P<0.05). The incidence of gastrointestinal bleeding and deep venous thrombosis in the two groups were not statistically significant (P>0.05). The distribution of GOS score in the two groups at 6 months after operation was better than that at 3 months after operation. The distribution of GOS score at 3 months after operation and 6 months after operation in the study group were better than that of the control group (P<0.05). Conclusion: Tissue dilator assisted neuroendoscopy in the treatment of hypertensive cerebral hemorrhage can effectively shorten the operation time and reduce the amount of bleeding volume.Its hematoma clearance rate is also higher. The incidence of postoperative complications is low and the prognosis is good.