高压氧联合鼻内镜下微创手术治疗HICH的疗效分析

摘要

Objective To explore the efficacy of hyperbaric oxygen combined with nasal-endoscopic minimally invasive surgery on the treatment of hypertensive intracerebral hemorrhage (HICH).Methods A total of 196 HICH patients who had received surgical treatment in our hospital were retrospectively analyzed and divided into group A(n =62,treated with routine large trauma craniotomy),group B (n=54,treated with simple nasal-endoscopic minimally invasive surgery) and group C (n=80,treated with hyperbaric oxygen with nasal-endoscopic minimally invasive surgery).The rehabilitation of neurological function and the quality of life in the three groups were compared after the six-month follow-up visit.Results Three patients in group A,two ones in group B and four ones in group C died,showing no statistical difference (P ＞ 0.05);the ORR of NIHSS score in groups A,B and C was 66.1％,70.4％ and 85.0％,respectively;the goodness rate of Barthel index score for ADL in groups A,B and C was 58.1％,64.8％ and 80.0％,respectively.The two rates in group C were significantly higher than those in groups A and B (P ＜ 0.05).Conclusion The efficacy of hyperbaric oxygen with nasal-endoscopic minimally invasive surgery on the treatment of HICH is better than that of simple nasal-endoscopic minimally invasive surgery or routine large trauma craniotomy.%目的 探讨高压氧联合鼻内镜下微创手术治疗高血压脑出血(hypertensive intracerebral hemorrhage,HICH)的疗效.方法 回顾性分析医院手术治疗的高血压脑出血患者196例,其中采用常规大骨瓣开颅手术治疗62例(A组),单纯鼻内镜下微创手术治疗54例(B组),高压氧联合鼻内镜下微创手术治疗80例(C组).术后随访6个月,比较各组神经功能康复情况及生活质量.结果 A组死亡3例,B组死亡2例,C组死亡4例,3组无统计学差异(P＞0.05);NIHSS评分总有效率A组为66.1％,B组为70.4％,C组为85.0％;生活能力Barthel指数评分评分:A组良好率为58.1％,B组为64.8％,C组为80.0％,C组均显著高于B组和A组(P＜0.05).结论 高压氧联合鼻内镜下微创手术治疗高血压脑出血,疗效优于单纯鼻内镜下微创手术或常规大骨瓣开颅手术.