解放军医学院学报Issue(4)：309-312,4.DOI:10.3969/j.issn.2095-5227.2015.04.003
高血压脑出血神经内镜手术与传统开颅手术疗效比较
Endoscopic surgery with traditional craniotomy in management of hypertensive intracerebral hemorrhage：A comparative study
摘要
Abstract
Objective To compare the effectiveness and prognosis of endoscopic evacuation with traditional craniotomy in patients with hypertensive intracerebral hemorrhage (HICH).Methods A total of 164 consecutive patients with supratentorial hypertensive intracerebral hemorrhage admitted to the department of neurosurgery in our hospital from June 2009 to December 2013 were recruited into this study, and they were divided into endoscopy group (n=89) and craniotomy group (n=75) according to the surgical method. Clinical data about these patients were collected and comparisons of clinical outcome and long-term prognosis between these 2 groups were made.Results There were no significant differences of preoperative data between these two groups (P>0.05). The evacuation rate of hematoma in endoscopy group (90.3%±5.6%) was significantly higher than that in craniotomy group (82.1%±8.3%) (P<0.01). The operation time was 1.7±0.8 h for endoscopy group and 5.1±1.6 h for craniotomy group (P<0.01). The average blood loss during operation was 94.4±99.1 ml for endoscopy group and 610.7±612.7 ml for craniotomy group (P<0.01). Mean GCS score a week after surgery was 11.6±3.3 for endoscopy group and 8.4±4.5 for craniotomy group (P<0.01). The average hospitalization time was 11.6±3.3 d for endoscopy group and 8.4±4.5 d for craniotomy group (P<0.05). The mean Modified Rankin Scales (mRS) of 6-month follow-up was 3.2±1.8 for endoscopy group and 4.1±1.6 for craniotomy group (P<0.05). Patients in endoscopy group got a better prognosis than patients in craniotomy group.Conclusion Endoscopic evacuation is a technically feasible, minimally invasive and highly efficient technique for the management of hypertensive intracerebral hemorrhage. Endoscopic surgery can improve the outcome and prognosis of patients with supratentorial hypertensive intracerebral hemorrhage.关键词
高血压脑出血/神经内镜/微侵袭神经外科Key words
hypertensive intracerebral hemorrhage/neuroendoscopy/minimally invasive neurosurgery分类
医药卫生引用本文复制引用
徐兴华,陈晓雷,刘磊,武琛,张军,许百男..高血压脑出血神经内镜手术与传统开颅手术疗效比较[J].解放军医学院学报,2015,(4):309-312,4.基金项目
国家自然科学基金项目(81171109) Supported by the National Natural Science Foundation of China(81171109) （81171109）
