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目的观察神经导航联合神经内镜治疗高血压脑出血的临床疗效。方法 132例高血压脑出血患者,应用神经导航联合神经内镜治疗高血压脑出血50例(神经内镜组)与常规开颅血肿清除术治疗高血压脑出血82例(常规手术组)临床资料进行回顾性分析,比较两组的手术时间、术中失血量、血肿清除率及术后6个月日常生活能力(ADL)。结果神经内镜组平均手术时间[(2.1±1.2)小时],明显短于常规手术组[(4.1±2.1)小时](P<0.01)。平均失血量神经内镜组为(52.5±11.3)ml,常规手术组为(458.2±185.2)ml,两组比较差异有统计学意义(t=6.125,P<0.01)。神经内镜组颅内血肿平均清除率[(94.8±5.2)%]明显高于常规手术组[(81.2±18.8)%](P<0.05)。依据ADL分级法,神经内镜组预后优于常规手术组(P<0.05)。结论神经导航联合神经内镜治疗高血压脑出血手术切口小,骨窗小,手术时间短,术中失血量少等优势。
Objective To observe the clinical effects of neuronavigation and neuroendoscopy in the treatment of hypertensive intracerebral hemorrhage. Methods A total of 132 patients with hypertensive intracerebral hemorrhage were treated with neuro navigation combined with endoscopic neuroendoscopy for the treatment of hypertensive intracerebral hemorrhage in 50 patients (neuroendoscopic group) and conventional craniotomy for hemorrhage in 82 patients (conventional surgery group) A retrospective analysis was performed to compare operative time, intraoperative blood loss, hematoma clearance, and ADL 6 months postoperatively. Results The average time of operation in the endoscopic group was (2.1 ± 1.2) hours, significantly shorter than that in the control group (4.1 ± 2.1) hours (P <0.01). The mean blood loss was (52.5 ± 11.3) ml in the group of endotoxemia and (458.2 ± 185.2) ml in the group of conventional surgery, the difference was statistically significant (t = 6.125, P <0.01). The mean clearance rate of intracranial hematoma in neuroendoscopy group was significantly higher than that in the conventional surgery group (94.8 ± 5.2% vs 81.2 ± 18.8%, P <0.05). According to ADL classification, the prognosis of neuroendoscope group was better than that of the conventional operation group (P <0.05). Conclusion Nerve navigation combined with endoscopic neurosurgical treatment of hypertensive intracerebral hemorrhage small incision, small bone window, short operative time, less blood loss during surgery.