B超引导神经内镜微创手术治疗高血压脑出血的临床研究

摘要

目的 探讨B超引导神经内镜微创手术治疗高血压脑出血(HICH)的临床效果,评价及其应用价值.方法 将150例HICH患者随机分成两组,分别为研究组75例,应用B超引导神经内镜微创手术治疗;对照组75例,接受开颅血肿清除术治疗.对两组患者的GOS优良率、血肿清除率、术中失血量、颅内压变化及格拉斯哥昏迷评分(GCS)、并发症发生率差异进行统计学分析.结果 治疗后两组患者的GOS优良率及血肿清除率均明显高于治疗前(P＜0.05);研究组患者术中失血量明显少于对照组(P＜0.05);治疗后两组患者的颅内压明显低于治疗前(P＜0.05),且研究组患者治疗后的颅内压显著优于对照组(P＜0.05);治疗后两组患者的GCS评分明显高于治疗前(P＜0.05),且研究组患者治疗后的GCS评分显著高于对照组(P＜0.05);治疗后,两组患者发生颅内感染4例,脑积水1例,其他并发症11例;研究组患者并发症发生率明显低于对照组(P＜0.05).结论 B超引导神经内镜微创手术治疗HICH的疗效显著,具有较高的临床应用价值.%Objective To evaluate the application value of minimally invasive operation guided by B ultrasound by investigating the clinical effect of in hypertensive intracerebral hemnorrhage (HICH).Method One hundred and fifty cases of HICH patients were randomly divided into two groups,seventy-five cases in the study group,treated by endoscopic minimally invasive surgery guided ultrasound;and control group of seventy-five cases,received craniotomy hematoma removal treatment.Statistically analyzed the fineness ratios of GOS,clearance rate of hematoma,blood lose during operation,intracranial pressure change and Glasgow Coma Scale (GCS),and the incidence of complications in each group.Results The fineness ratios of GOS and hematoma clearance rate of the two groups were significantly higher than those before treatment (P＜0.05);blood loss during operation of study group was significantly less than the control group (P＜0.05);the intracranial pressure of patients in two groups was significantly lower than that before treatment (P＜0.05);and the intracranial pressure of study group after treatment,the pressure was significantly better than the control group (P＜0.05);the GCS scores of patients in two groups after treatment were significantly higher than those before treatment (P＜0.05),and the GCS scores of study group were significantly higher than the control group (P＜0.05).There were four patients occurred with intracranial infection,one patent with hydrocephalus and eleven patients with other complications in two groups,the incidence of complications were significantly lower than the control group (P＜0.05).Conclusion Minimally invasive endoscopic guided by ultrasound in the treatment of HICH has a significant effect,with a high clinical value.