内镜手术治疗基底节区高血压脑出血的效果观察.docxVIP

内镜手术治疗基底节区高血压脑出血的效果观察 　　[摘要]目的探討内镜手术治疗基底节区高血压脑出血的效果。方法选择2018年7～12月在我院诊断治疗的基底节区高血压脑出血患者60例的临床资料进行回顾性分析。其中30例患者采用神经内镜下手术治疗为内镜组，30例患者采用小骨窗手术治疗为对照组。比较两组的手术时间、术后残余血量、血肿清除率、再出血率、术前及术后24hgcs评分，术后6个月gos预后评价。结果（1）内镜组手术时间显著短于对照组，残余血肿量显著低于对照组，血肿清除率显著高于对照组，差异有统计学意义（p0.05）;两组再出血率比较，差异无统计学意义（p0.05）。（2）两组治疗后24hgcs评分较治疗前显著提高，差异有统计学意义（p0.05）;治疗后内镜组gcs评分显著高于对照组，差异有统计学意义（p0.05）。（3）秩和检验显示，内镜组gos预后评价显著优于对照组，差异有统计学意义（p0.05）。结论内镜下手术治疗基底节区高血压脑出血操作相对简单，创伤更小，术中出血量少，血肿清除率高，术后24hgcs评分更好，术后6个月gos评分更好，说明该方法创伤小，血肿清除率高，术后近期及远期预后更好。 　　[关键词]内镜;显微手术;基底节;高血压脑出血 　　[中图分类号]r651.1[文献标识码]b[文章编号]1673-9701（2020）10-0058-04 　　[abstract]objectivetoinvestigatetheeffectsofendoscopicsurgeryinthetreatmentofhypertensivecerebralhemorrhageinbasalgangliaregion.methodsretrospectiveanalysiswasconductedontheclinicaldataof60patientswithhypertensivecerebralhemorrhageinbasalgangliaregiondiagnosedandtreatedinourhospitalfromjulytodecember2018.amongwhich，30patientsweretreatedwithneuroendoscopicsurgeryastheendoscopicgroup，while30patientsweretreatedwithsmallbonewindowsurgeryasthecontrolgroup.operationtime，postoperativeresidualbloodvolume，hematomaclearancerate，rebleedingrate，gcsscoresbeforeand24haftersurgery，gosprognosisevaluation（6monthsaftersurgery）werecomparedbetweenthetwogroups.results（1）comparedwiththecontrolgroup，theoperationtimeintheendoscopicgroupwassignificantlyshorter，theamountofresidualhematomawassignificantlylower，andthehematomaclearanceratewassignificantlyhigher，thedifferenceswerestatisticallysignificant（p0.05）;therewasnostatisticallysignificantdifferenceinrebleedingratebetweenthetwogroups（p0.05）.（2）at24haftertreatment，gcsscoresinthetwogroupsweresignificantlyhigherthanthosebeforetreatment，thedifferencewasstatisticallysignificant（p0.05）;aftertreatment，gcsscoreintheendoscopicgroupwassignificantlyhigherthanthatinthecontrolgroup，thedifferencewasstatisticallysignificant（p0.05）.（3）therank-sumtestshowedthatthegosprognosisevaluationintheendoscopicgroupwassignificantlybetterthanthatinthecontrolgroup，thedifferen