CAJ | 학술논문

目的：比较幕上高血压脑出血神经内镜微创手术与与开颅血肿清除术的临床疗效与特点。方法收集80例幕上高血压脑出血患者的手术时间、术中出血量、术后血肿清除量、术后颅内感染、术后6个月GOS等临床资料，根据其治疗方案分为神经内镜微创手术组与开颅血肿清除术组，以第6个月GOS评分作为预后指标。采用SPSS13.0软件，比较2组手术方式的手术时间、手术失血量、血肿清除率及其GOS预后评分的差别，比较手术疗效。结果神经内镜组手术时间上平均（1.5±0.8）h ，开颅组平均值为（3.5±1.1）h（P＜0.05）；神经内镜组术中出血量平均（40.0±19.7）mL ，开颅组平均（400.6±130.2）mL（P＜0.05）；神经内镜组血肿清除率平均（92.6±9.4）％，开颅组平均（73.1±21.1）％（P＜0.05）；术后颅内感染神经内镜组0例，开颅组3例（ P＜0.05）；随访6个月神经内镜组恢复良好18例，轻度残疾26例，重度残疾3例，植物状态1例，死亡1例。开颅组恢复良好6例，轻度残疾9例，重度残疾6例，植物状态4例，死亡1例，神经内镜组预后优于开颅组（P＜0.05）。结论神经内镜微创手术微创、快速、高效、医疗成本低，是治疗幕上高血压脑出血行之有效的一种手术方法。
목적：비교막상고혈압뇌출혈신경내경미창수술여여개로혈종청제술적림상료효여특점。방법수집80례막상고혈압뇌출혈환자적수술시간、술중출혈량、술후혈종청제량、술후로내감염、술후6개월GOS등림상자료，근거기치료방안분위신경내경미창수술조여개로혈종청제술조，이제6개월GOS평분작위예후지표。채용SPSS13.0연건，비교2조수술방식적수술시간、수술실혈량、혈종청제솔급기GOS예후평분적차별，비교수술료효。결과신경내경조수술시간상평균（1.5±0.8）h ，개로조평균치위（3.5±1.1）h（P＜0.05）；신경내경조술중출혈량평균（40.0±19.7）mL ，개로조평균（400.6±130.2）mL（P＜0.05）；신경내경조혈종청제솔평균（92.6±9.4）％，개로조평균（73.1±21.1）％（P＜0.05）；술후로내감염신경내경조0례，개로조3례（ P＜0.05）；수방6개월신경내경조회복량호18례，경도잔질26례，중도잔질3례，식물상태1례，사망1례。개로조회복량호6례，경도잔질9례，중도잔질6례，식물상태4례，사망1례，신경내경조예후우우개로조（P＜0.05）。결론신경내경미창수술미창、쾌속、고효、의료성본저，시치료막상고혈압뇌출혈행지유효적일충수술방법。
Objective To evaluate endoscopic surgery of hypertensive intracerebral basal ganglia hemorrhage comparing with craniotomy.Methods 80 hypertensive intracerebral basal ganglia hemorrhage cases were randomly divided into 2 groups:endoscopy group (56 cages) and craniotomy group (26 cases).The clinical results and characteristics were compared between 2 groups.Results There were no significant differences of preoperative clinical data between 2 groups(P>0.05).Operating du-ration of endoscopy group (1.5 ± 0.8)h was shorter than that of craniotomy group (3.5 ± 1.1)h (P<0.05).Blood loss of en-doscopy group (40.0 ± 19.7)ml was much less than that of craniotomy group (400.6 ± 130.2)mL (P<0.05).Rates of hemato-ma evacuation in endoscopy group (92.6 ± 9.4)% were higher compared with craniotomy group (73.1 ± 21.1)% (P<0.05).Intracranial infection of endoscopy group is 0 case and craniotomy group is 3 cases (P<0.05).In endoscopy group ,49 patients were followed up and evaluated by Glasgow Outcome Scale for at least 6 months.Among them ,18 patients showed good recov-ery ;26 patients showed moderate disability ;3 patients showed severe disability ,one patients showed vegetative survival ,and one patient died ,respectively.In craniotomy group ,26 patients were followed up and evaluated by Glasgow Outcome Scale for at least 6 months.Among them ,6 patients showed good recovery ,9 patients showed moderate disability ,6 patients showed se-vere disability ,4 patients showed vegetative survival and one patients died respectively.The GOS outcomes of endoscopy group were better than those of craniotomy group (P<0.05).Conclusion Endoscopic surgery is a efficient and minimally invasive and operating technique for the treatment of hypertensive basal ganglia intracerebral hemorrhage.