摘要
目的探究内镜辅助下血肿清除加去骨瓣减压术治疗重症脑出血患者的效果。方法选取普宁华侨医院2019年3月-2021年3月收治的60例重症脑出血患者,按照简单随机数字表法分为对照组(n=30)和观察组(n=30),对照组采用内镜辅助下血肿清除术,观察组在对照组基础上采用去骨瓣减压术治疗。评估两组脑内血肿的清除情况、血清炎症因子、预后情况。结果术后3d,观察组血肿清除率高于对照组(P<0.05);术前两组患者血清肿瘤坏死因子ɑ(TNF-ɑ)、白细胞介素-1β(IL-1β)对比,差异无统计学意义(P>0.05),术后两组均降低,且观察组低于对照组(P<0.05);术前两组患者神经功能缺损评分(NIHSS)、格拉斯哥预后量表(GOS)、日常生活活动能力量表(ADL)评分对比,差异无统计学意义(P>0.05),随访结束后两组NIHSS评分均降低且观察组低于对照组(P<0.05),两组GOS以及ADL评分均升高且观察组高于对照组(P<0.05)。结论内镜辅助下血肿清除加去骨瓣减压术治疗重症脑出血患者通过提高血肿清除率,减轻术后炎症反应,进而加快患者神经功能的恢复,改善预后。
Objective To explore the effect of endoscopic assisted hematoma removal and bone flap decompression in the treatment of patients with severe intracerebral hemorrhage.Methods 60 patients with severe intracerebral hemorrhage treated in Puning Overseas Chinese Hospital from March 2019 to March 2021 were randomly divided into control group(n=30)and observation group(n=30).The control group was treated with endoscopic assisted hematoma removal,and the observation group was treated with bone flap decompression on the basis of the control group.The clearance of intracerebral hematoma,serum inflammatory factors and prognosis were evaluated.Results Three days after operation,the hematoma clearance rate in the observation group was higher than that in the control group(P<0.05);there was no significant difference in serum tumor necrosis factorɑ(TNF-ɑ),Interleukin-1β(IL-1β)of the two groups before operation(P>0.05),which were lower in the observation group than in the control group after operation(P<0.05);there was no significant difference in the scores of neurological deficit score(NIHSS),Glasgow prognosis scale(GOS)and activity of daily living scale(ADL)between the two groups before operation(P>0.05).After follow-up,the NIHSS scores of the two groups decreased and the observation group was lower than that of the control group(P<0.05).The scores of GOS and ADL in the two groups increased and the observation group was higher than that of the control group(P<0.05).Conclusion Endoscopic assisted hematoma removal and bone flap decompression in the treatment of patients with severe intracerebral hemorrhage can improve the hematoma removal rate,reduce the postoperative inflammatory reaction,accelerate the recovery of neurological function and improve the prognosis.
作者
黄燕钦
吴彬冰
杨镇松
HUANG Yanqin;WU Binbing;YANG Zhensong(Area 1 Outside Puning Overseas Chinese Hospital,Puning,Guangdong,515300)
出处
《智慧健康》
2022年第13期87-90,共4页
Smart Healthcare
关键词
内镜
血肿清除
去骨瓣减压术
重症脑出血
Endoscopy
Hematoma removal
Decompressive osteotomy
Severe cerebral hemorrhage
