Effects of two Different Surgical Methods on Perioperative Indexes ADL Score and Postoperative Complications in Patients with Hypertensive Intracerebral Hemorrhage in Basal Ganglia
ZHENG Xi, SUN Dunxin, YIN Jie
The 474 Hospital of PLA, Xinjiang Urumqi 830013, China
Abstract:Objective:To analyze the effects of two different surgical methods on perioperative indexes, activities of daily living (ADL) score and postoperative complications in patients with hypertensive intracerebral hemorrhage (HICH) in basal ganglia. Methods: 86 patients with HICH in basal ganglia who were admitted to the hospital during the period from January 2015 to January 2018 were selected as subjects. According to different surgical methods, they were divided into the observation group (40 cases) and the control group (46 cases). The observation group was treated by neuroendoscopic minimally invasive surgery, and the control group was treated by small bone window craniotomy microsurgery. The perioperative indexes and changes of intracranial pressure within 7 days after surgery were recorded. The ADL scale and the Glasgow Outcome Scale (GOS) were used to evaluate the activities of daily living and prognosis within 6 months after surgery, and complications were recorded. Results: The surgical time, intraoperative blood loss and hospital stay of the observation group were shorter/less than those of the control group, and the hematoma clearance rate was higher than that in the control group (P<0.05). The intracranial pressure of the observation group was significantly lower than that of the control group at 3 days and 7 days after surgery (P<0.05). The ADL scores of the observation group were higher than those of the control group at 3 months and 6 months after surgery (P<0.05). The GOS grade of the observation group was better than the control group at 6 months after surgery (P<0.05), and the incidence of complications in the observation group within 6 months after surgery was lower than that in the control group (5.00% vs 19.57%) (P<0.05). Conclusion: Compared with small bone window craniotomy microsurgery, neuroendoscopic minimally invasive surgery for HICH in basal ganglia can significantly improve the perioperative indexes, effectively remove hematoma, reduce intracranial pressure, improve postoperative activities of daily living and the prognosis.
郑玺, 孙敦鑫, 殷捷. 两种不同手术方式治疗对高血压基底节区脑出血患者围术期指标ADL评分及术后并发症的影响【项目基金】新疆维吾尔自治区自然科学基金,(编号:2015201C3946)[J]. 河北医学, 2019, 25(3): 618-622.
ZHENG Xi, SUN Dunxin, YIN Jie. Effects of two Different Surgical Methods on Perioperative Indexes ADL Score and Postoperative Complications in Patients with Hypertensive Intracerebral Hemorrhage in Basal Ganglia. HeBei Med, 2019, 25(3): 618-622.
[1] Chen GF,Ping L,Zhou SK,et al.Early prediction of death in acute hypertensive intracerebral hemorrhage[J].Exp Ther Med,2016,11(1):83~88. [2] 韩繁龙,张国来,吴生贵,等.小骨窗与大骨瓣开颅血肿清除术治疗高血压脑出血的疗效分析[J].现代生物医学进展,2016,16(33):6542~6545. [3] 周焰.原发性高血压伴脑出血患者测定血清生化指标和生物标志物水平的临床价值[J].标记免疫分析与临床,2015,22(2):101~105. [4] 王为文,张伟,闫忠军,等.小骨窗微创手术治疗急性基底节区高血压脑出血疗效分析[J].临床军医杂志,2017,45(12):1226~1229,1232. [5] 齐亮,韩辉,郑金玉,等.神经内镜手术与显微镜手术治疗高血压基底节区脑出血的有效性及安全性研究[J].神经损伤与功能重建,2018,13(1):29~30. [6] Gotob S,Hata J,Ninomiya T,et al.Trends in the incidence and survival of intracerebral hemorrhage by its location in a Japanese community[J].Circ J,2014,78:403~409. [7] 刘万荣,魏忠,方有利,等.传统骨瓣开颅血肿清除术与小骨窗入路血肿清除术治疗基底节区高血压脑出血的临床疗效对比观察[J].安徽医药,2017,21(10):1844~1846. [8] 范广明,张文,毛振立,等.神经内镜微创手术与小骨窗开颅显微手术治疗幕上高血压脑出血的临床效果[J].解放军医药杂志,2017,29(1):90~93.