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神经内镜清除与导航穿刺引流治疗丘脑出血破入脑室的效果比较

Comparison of clinical efficiency between neuroendoscope-assisted evacuation and navigation-assisted puncture in treating thalamic hemorrhage breaking into the ventricle

  • 摘要:
    目的 比较神经内镜下血肿清除术与导航穿刺引流术治疗丘脑出血破入脑室的临床效果。
    方法 回顾性选择2022年1月至2024年2月在皖南医学院附属太和医院治疗的93例丘脑出血破入脑室的患者。患者分别行神经内镜下丘脑血肿清除术联合对侧脑室外引流术(44例,内镜组)和导航下丘脑血肿穿刺引流术联合对侧脑室外引流术(49例,导航组)。比较两组患者手术情况、疗效及预后等指标。
    结果 与导航组相比,内镜组手术时间较长、术中出血量较多、住院费用较高(P<0.05)。内镜组术后3 d血肿清除率大于导航组、住院时间短于导航组(P<0.05)。两组患者术后颅内感染发生率差异无统计学意义。内镜组患者术后1周格拉斯哥昏迷量表(GCS)评分及术后3个月格拉斯哥预后量表(GOS)评分均大于导航组(P<0.01)。
    结论 神经内镜辅助血肿清除较导航辅助穿刺引流能提高丘脑出血破入脑室患者的血肿清除率、缩短住院时间,并改善患者预后。

     

    Abstract:
    Objective To compare the clinical efficacy of neuroendoscope-assisted evacuation and navigation-assisted puncture drainage in treating thalamic hemorrhage breaking into the ventricle.
    Methods A retrospective analysis was conducted on the clinical data of 93 patients with thalamic hemorrhage breaking into the ventricle at Taihe Hospital of Wannan Medical College between January 2022 and February 2024. The patients received neuroendoscope-assisted removal of thalamic hematoma combined with contralateral extraventricular drainage (n=44, neuroendoscope group) and navigation-assisted thalamic hematoma puncture drainage combined with contralateral extraventricular drainage (n=49, navigation group), respectively. The treatment efficacy, surgical situation, and prognosis between the two groups were compared.
    Results The neuroendoscope group had longer operation duration, more intraoperative blood loss, higher hospitalization costs than the navigation group (P<0.05). The neuroendoscope group had higher hematoma clearance rate 3rd after surgery and shorter length of stay than the navigation group (P<0.05). There was no significant difference in the incidence of intracranial infection after surgery between the two groups. The neuroendoscope group had higher Glasgow coma scale (GCS) score at 1 week after surgery and Glasgow outcome scale (GOS) score at 3 months after surgery (P<0.01).
    Conclusions Compared with navigation-assisted puncture, neuroendoscope-assisted evacuation can improve the thalamic hemorrhage clearance rate, shorten the length of stay, and improve the prognosis of patients.

     

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