本文選題：神經(jīng)內(nèi)鏡 + 鉆孔引流��； 參考：《內(nèi)蒙古大學(xué)》2017年碩士論文

【摘要】：近年來,大多數(shù)高血壓腦出血患者采用微創(chuàng)手術(shù)治療后取得了良好的效果,但臨床上對于不同微創(chuàng)手術(shù)術(shù)式之間的優(yōu)劣進行統(tǒng)計學(xué)分析比較的報道較少[1]。本文收集巴彥淖爾市醫(yī)院神經(jīng)外科2014年3月—2016年3月收治的65例高血壓腦出血手術(shù)患者病例,隨機分為神經(jīng)內(nèi)鏡手術(shù)組和鉆孔引流手術(shù)組,對兩種術(shù)式治療腦出血的優(yōu)缺點進行了比較,為腦出血患者選擇更好的微創(chuàng)手術(shù)方式提供依據(jù)。主要結(jié)果如下:(1)患者性別、年齡、入院GCS評分及術(shù)前血腫量均無統(tǒng)計學(xué)意義,保證了患者入組的隨機性。(2)在術(shù)后殘余血腫量及血腫清除率方面,兩個手術(shù)組具有明顯的統(tǒng)計學(xué)意義(P0.001),內(nèi)鏡組具有明顯優(yōu)勢。(3)在術(shù)后并發(fā)癥方面,內(nèi)鏡組的肺部感染發(fā)生率明顯低于鉆孔組(P=0.0220.05)。而術(shù)后再出血、顱內(nèi)感染、消化道出血、電解質(zhì)紊亂、腦積水等并發(fā)癥的發(fā)生率,兩種手術(shù)方式的差異不明顯(P0.05)。(4)在出血后水腫持續(xù)時間方面,內(nèi)鏡組的水腫持續(xù)時間比鉆孔組短(P0.001),更加有利于患者術(shù)后恢復(fù)。(5)在術(shù)后6個月患者恢復(fù)方面,內(nèi)鏡組優(yōu)于鉆孔組,具有統(tǒng)計學(xué)意義(P0.05)。神經(jīng)內(nèi)鏡輔助下清除腦內(nèi)血腫技術(shù),具有微創(chuàng)、直視、高效等優(yōu)點,大大提高了血腫的即時清除率,減少了術(shù)后合并癥,降低了致殘率,改善了患者的預(yù)后,有望成為外科治療高血壓腦出血的首選術(shù)式。
[Abstract]:In recent years, most patients with hypertensive intracerebral hemorrhage have achieved good results after minimally invasive surgery, but there are few reports on the statistical analysis and comparison between different minimally invasive surgical procedures [1]. From March 2014 to March 2016, 65 patients with hypertensive intracerebral hemorrhage were randomly divided into two groups: endoscopic surgery group and borehole drainage group. The advantages and disadvantages of the two methods in the treatment of intracerebral hemorrhage were compared in order to provide evidence for better minimally invasive operation in patients with intracerebral hemorrhage. The main results were as follows: (1) gender, age, admission GCS score and preoperative hematoma volume were not statistically significant, which ensured the randomness of the patients entering the group. (2) the residual hematoma volume and hematoma clearance rate after operation were not statistically significant. The incidence of pulmonary infection in the endoscopic group was significantly lower than that in the borehole group (P0.0220.05). However, the incidence of postoperative rebleeding, intracranial infection, gastrointestinal bleeding, electrolyte disturbance, hydrocephalus and other complications were not significantly different (P0.05). (4). The duration of edema in the endoscopic group was shorter than that in the drilling group (P0.001), which was more conducive to postoperative recovery. (5) the endoscopic group was better than the borehole group in the recovery of patients 6 months after operation (P0.05). The technique of endoscope assisted intracerebral hematoma removal has the advantages of minimally invasive, direct vision and high efficiency. It greatly improves the immediate clearance rate of hematoma, reduces postoperative complications, reduces the rate of disability and improves the prognosis of the patients. It is expected to be the first choice for surgical treatment of hypertensive intracerebral hemorrhage.
【學(xué)位授予單位】：內(nèi)蒙古大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R651.12

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