老年基底节区脑出血微侵袭手术治疗的临床疗效观察OACSTPCD

Objective To observe clinical effects of basal ganglia hemorrhage in the elderly by minimally invasive surgery.Methods Retrospective analysis method was adopted.From January 2020 to December 2022,60 basal ganglia hemorrhage elderly patients were collected.The endoscope group had 20 patients who accepted hematoma clearance by neuroendoscope through middle frontal gyrus,the microscope group had 20 patients who accepted hematoma clearance by microscope through lateral fissure,the puncture group had 20 patients who accepted hematoma clearance by soft channel puncture and catheter drainage.Operative time,intraoperative bleeding,postoperative residual hematoma in the operative area,postoperative rebleeding,Glasgow Coma Scale(GCS),National Institutes of Health Stroke Scale(NIHSS)before and 7 days after surgery,and Glasgow Outcome Scale(GOS)6 months after surgery were observed.Results GCS and NIHSS scores of three groups were significantly improved 7 days after oper-ation,which had significant difference among three groups(P<0.05).The endoscopic group and microscope group were signifi-cantly better than the puncture group(P<0.05).GOS scores of three groups were significantly different 6 months after operation,and the endoscopy group and microscope group were significantly better than the puncture group(P<0.05).The operation time,intraoperative hemorrhage and postoperative residual hematoma in three groups were significantly different(P<0.05).The opera-tion time and intraoperative hemorrhage in puncture group were significantly less than those in endoscopic group and microscope group(P<0.05),but the postoperative residual hematoma in puncture group was significantly more than those in endoscopic group and the microscope group(P<0.05).The number of postoperative rebleeding cases in puncture group was significantly higher than that in microscope group(P<0.05).There was significant difference in postoperative pulmonary infection and urinary tract infection among three groups(P<0.05).The puncture group had significantly higher pulmonary infections,urinary tract infec-tions,and surgical site infections than the endoscopic group(P<0.05).Conclusion In clinical practice,surgical methods should be selected according to the specific conditions of elderly patients with basal ganglia hemorrhage.If conditions permit,it is pre-ferred to clear the hematoma under neuroendoscope,the short-term and long-term efficacy is good,and the incidence of postopera-tive complications is low.