神经内镜联合颅内压监测治疗基底节区脑出血的疗效观察*

Clinical observation of hypertensive cerebral hemorrhage by endoscopic surgery combined with intracranial pressure monitoring*

摘要:

观察神经内镜联合颅内压监测治疗基底节区脑出血的疗效，探讨有效治疗方法。方法?收集68例高血压脑出血患者，分为神经内镜下血肿清除联合对侧脑室穿刺颅内压监测组（A组，20例）；锥颅血肿穿刺引流术组（B组，25例）；开颅血肿清除术组（C组，23例）。比较3组患者术后的甘露醇使用次数、术后监护时间、气管切开率及预后情况。结果?①甘露醇使用次数：A组使用甘露醇次数（17.25±2.55）明显少于B组（20.32±2.08），差异有统计学意义（P?<0.05）；②术后监护时间：A组（63.60±11.74）h明显少于B组（104.64±16.80）h和C组（138.78±23.95）h，差异有统计学意义（P?<0.05）；③气管切开率：A组患者的气管切开率（5.0%）明显低于B组（36.0%）和C组（34.8%），差异有统计学意义（P?<0.05）；④预后：A组患者的预后（100.0%）优于B组（72.0%）和C组（82.6%），差异有统计学意义（P?<0.05）。结论?神经内镜联合颅内压监测治疗基底节区脑出血患者，是一种明确有效的手术方法。

Abstract:

To observe the effect of endoscopic surgery combined with intracranial pressure monitoring in treatment of hypertensive cerebral hemorrhage, and to explore the effective treatment method.?Methods?From October 2015 to May 2017 we collected 68 cases of hypertensive cerebral hemorrhage patients for the study. The patients were divided into three groups according to the treatment they received, 20 cases endoscopic surgery combined with intracranial pressure monitoring; 25 cases of the transcranial puncture drainage and intracranial pressure monitoring; 23 cases of conventional craniotomy. Then compare the mannitol application times, monitoring time in the intensive care unit, tracheotomy rate, and prognosis of the three groups.?Results?The use of mannitol in endoscopic group (17.25?±?2.55) were less than that in transcranial puncture group (20.32?±?2.08) (P?