目的 探究应用神经内镜手术和钻孔引流手术于治疗幕上中等出血量高血压性脑出血患者的疗效.方法 随机选取2021年1月—2024年1月山东省邹平市人民医院收治的100例幕上中等出血量高血压性脑出血患者为研究对象,按照不同手术方法分为两组,每组50例.对照组接受钻孔引流手术治疗,观察组接受神经内镜手术治疗.比较两组血肿量、血肿清除率、临床相关指标、神经功能、日常生活能力评分和并发症发生率.结果 治疗后,观察组血肿量(8.45±3.19)mL少于对照组的(15.58±3.12)mL,血肿清除率(85.60±11.75)%高于对照组的(64.40±18.64)mL,差异有统计学意义(t=11.299、6.803,P均<0.05).相对于对照组,观察组手术时间更长、术中出血量更多、住院时间更短,差异有统计学意义(P均<0.05).观察组美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分低于对照组,日常生活活动能力评分(Modified Barthel Index,MBI)高于对照组,差异有统计学意义(P均<0.05).观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05).结论 采用神经内镜手术于治疗幕上中等出血量高血压性脑出血患者,虽然手术时间较长,术中出血量较多,但疗效比较明显,术后血肿量较少,血肿清除率较高,住院时间较短,同时能够有效改善神经功能,增强日常生活活动能力,安全性高.
Analysis of the Therapeutic Effect of Neuroendoscopy and Drilling Drain-age Surgery on Moderate Supratentorial Hypertensive Intracerebral Hem-orrhage
Objective To explore the efficacy of neuroendoscopic surgery and drilling drainage surgery in the treat-ment of patients with moderate supratentorial hypertensive intracerebral hemorrhage.Methods From January 2021 to January 2024,100 patients with supratentorial moderate bleeding hypertensive cerebral hemorrhage admitted to Zoup-ing People's Hospital of Shandong Province were randomly selected as the research objects,and they were divided into two groups according to different surgical methods,with 50 cases in each group.The control group received drill-ing drainage surgery,and the observation group received neuroendoscopic surgery.The hematoma volume,hematoma clearance rate,clinical related indicators,neurological function,daily living ability score and complication rate were compared between the two groups.Results After treatment,the hematoma volume(8.45±3.19)mL in the observation group was less than(15.58±3.12)mL in the control group,and the hematoma clearance rate(85.60±11.75)％ was higher than(64.40±18.64)％ mL in the control group,the differences were statistically significant(t=11.299,6.803,both P<0.05).Compared with the control group,the observation group had longer operation time,more intraoperative blood loss and shorter hospitalization time,and the differences were statistically significant(both P<0.05).The Na-tional Institute of Health Stroke Scale(NIHSS)score of the observation group was lower than that of the control group,and the Modified Barthel Index(MBI)score was higher than that of the control group,and the differences were statisti-cally significant(both P<0.05).The total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The use of neuroendoscopic surgery in the treatment of patients with moderate to high volume hypertensive intracerebral hemorrhage above the curtain,al-though the surgery time is longer and the intraoperative bleeding is more significant,has a significant therapeutic ef-fect.The postoperative hematoma volume is less,the hematoma clearance rate is higher,the hospital stay is shorter,and it can effectively improve neurological function,enhance daily life activities,have fewer complications,and high safety.
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