广东药科大学附属第一医院 神经外科，广东 广州 510080
Department of Neurosurgery, the First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou, Guandong 510080, China
目的 探讨脑CT三维定位贴在神经内镜治疗高血压脑出血中的应用价值。方法 回顾性分析45例经神经内镜治疗的高血压脑出血患者，按照定位方法分为两组，徒手定位组（n = 24）和定位贴组（n = 21）。比较两组患者手术时间、术中出血量和血肿清除率。采用美国国立卫生研究院卒中量表（NIHSS）评价患者治疗前后神经功能缺损情况，对比术后1个月两组患者神经功能改善情况。结果 定位贴组手术时间短于徒手定位组，血肿清除率高于徒手定位组，组间比较，差异均有统计学意义（P < 0.05）。定位贴组术后1个月神经功能缺损改善更明显。结论 应用脑CT三维定位贴定位血肿行神经内镜手术，具有定位精确、手术时间短、术中出血少、血肿清除率高和恢复快等优点，值得临床推广应用。
Objective To investigate the value of brain CT three-dimensional localization patch in treatment of hypertensive cerebral hemorrhage by neuroendoscopy.Methods Clinical date of 45 patients with hypertensive cerebral hemorrhage treated by neuroendoscopy were retrospectively analyzed. The patients were divided into two groups according to the localization method: the manual localization group (n = 24) and the brain CT three-dimensional localization patch group (n = 21). The operation time, intraoperative bleeding volume and hematoma clearance rate were compared between the two groups. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the neurological deficit before and after treatment, and the neurological improvement was compared between the two groups one month after operation.Results The time of operation in brain CT three-dimensional localization patch group were shorter than that of manual localization group, the clearance rate of hematoma was higher than that of manual localization group, and the difference between groups was statistically significant (P < 0.05). The improvement of nerve function defect after treatment was more obvious in the brain CT three-dimensional localization patch group.Conclusion Brain CT three-dimensional localization patch guided neuroendoscopy for hematoma has the advantages of accurate location, shorter operation time, less intraoperative blood loss, satisfactory hematoma clearance, and rapid recovery.