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显微镜联合内镜治疗高血压脑出血的效果
程扬      叶新新      马蒙      吴康佳      张常浩
北京燕化医院神经外科,北京   102500
Effect of microscope combined with endoscopy in the treatment of hypertensive cerebral hemorrhage
CHENG Yang   YE Xinxin   MA Meng   WU Kangjia   ZHANG Changhao#br#
Department of Neurosurgery, Beijing Yanhua Hospital, Beijing   102500, China
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摘要 目的 观察显微镜联合内镜治疗高血压脑出血的效果。 方法 选取北京燕化医院神经外科2019年1月至2021年12月收治的124例高血压脑出血手术患者,根据随机数字表法将其分为观察组和对照组,各62例。观察组采取小骨窗开颅显微镜联合内镜血肿清除术,对照组采取小骨窗开颅显微镜下血肿清除术,比较两组血肿体积、血肿清除率、再出血发生率、手术时间、住院时间、格拉斯哥昏迷量表(GCS)及日常生活能力(ADL)评分。结果 观察组血肿清除率高于对照组,再出血发生率低于对照组,手术时间、住院时间均短于对照组,差异有统计学意义(P < 0.05)。术后两组GCS评分高于术前,且观察组高于对照组,差异有统计学意义(P < 0.05)。观察组术后6个月ADL评分高于对照组,差异有统计学意义(P < 0.05)。结论 显微镜联合内镜手术治疗高血压脑出血较单纯显微镜下手术,血肿清除更彻底,再出血率更低,能缩短手术时间及住院时间,可以作为临床治疗高血压脑出血的常用手段开展应用。
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程扬 叶新新 马蒙 吴康佳 张常浩
关键词 高血压脑出血小骨窗开颅显微镜神经内镜    
Abstract:Objective To observe the effect of microscope combined with endoscopy in the treatment of hypertensive cerebral hemorrhage. Methods A total of 124 patients with hypertensive cerebral hemorrhage admitted to Department of Neurosurgery in Beijing Yanhua Hospital from January 2019 to December 2021 were selected. They were divided into observation group and control group by random number table method, with 62 cases in each group. The observation group was treated with small bone window craniotomy microscope combined with endoscopic hematoma removal, the control group was treated with small bone window craniotomy and hematoma removal under microscope. The hematoma volume, hematoma clearance rate, rebleeding rate, operation time, hospital stay, Glasgow coma scale (GCS), and activity of daily living (ADL) scores were compared between the two groups. Results The hematoma clearance rate of the observation group was higher than that of the control group, the rebleeding rate of the observation group was lower than that of the control group, and the operation time and hospital stay of the observation group were shorter than those of the control group, the differences were statistically significant (P < 0.05). The GCS scores of the two groups after operation were higher than those before operation, and that of the observation group was higher than that of the control group, the differences were statistically significant (P < 0.05). ADL score of the observation group was higher than that of the control group six months after operation, the difference was statistically significant (P < 0.05). Conclusion Microscope combined with endoscopy in the treatment of hypertensive cerebral hemorrhage has more complete hematoma removal, lower rebleeding rate, shorter operation time and hospital stay. It can be used as a common means for clinical treatment of hypertensive cerebral hemorrhage.
Key wordsHypertensive cerebral hemorrhage    Small bone window    Craniotomy    Microscope    Neuroendoscopy
    
基金资助:北京燕化医院院内基金项目(YH1903)。
引用本文:   
程扬 叶新新 马蒙 吴康佳 张常浩. 显微镜联合内镜治疗高血压脑出血的效果[J]. 中国医药导报, 2022, 19(20): 79-82.
CHENG Yang YE Xinxin MA Meng WU Kangjia ZHANG Changhao. Effect of microscope combined with endoscopy in the treatment of hypertensive cerebral hemorrhage. 中国医药导报, 2022, 19(20): 79-82.
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https://www.yiyaodaobao.com.cn/CN/     或     https://www.yiyaodaobao.com.cn/CN/Y2022/V19/I20/79

 

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