作者：王立忠，孙慧渊，赵立辉，侯青，丁奇，闫俊飞，袁武，王唯，张晓宇

单位：

075000河北省张家口市第一医院神经外科

Units：

Department of Neurosurgery, Zhangjiakou First Hospital, Zhangjiakou 075000, China

关键词：

　颅内出血，高血压性；基底神经节出血；神经内镜手术；显微镜开颅手术；疗效比较研究

Keywords：

Intracranial hemorrhage, hypertensive; Basal ganglia hemorrhage; Endoscopic neurosurgery; Microscopiccraniotomy; Comparative effectiveness research

CLC：

R 743.34

DOI：

10.12114/j.issn.1008-5971.2023.00.208

Funds：

河北省2019年度医学科学研究课题计划项目（20191722）

摘要：

目的　比较神经内镜手术与显微镜开颅手术治疗基底核区高血压性脑出血（HICH）的效果。方法　回顾性选取2017年3月至2022年3月于张家口市第一医院神经外科接受手术治疗的基底核区HICH患者188例为研究对象。根据手术方式不同，将患者分为神经内镜组95例与显微镜组93例。显微镜组患者进行显微镜开颅手术，神经内镜组患者进行神经内镜手术。比较两组基线资料、手术相关指标（手术时间、术中出血量、血肿清除率、术后颅内感染发生率）、预后良好者占比。结果　神经内镜组手术时间短于显微镜组，术中出血量少于显微镜组，血肿清除率高于显微镜组（P＜0.05）；两组术后颅内感染发生率比较，差异无统计学意义（P＞0.05）。两组预后良好者占比比较，差异无统计学意义（P＞0.05）。结论　与显微镜开颅手术相比，神经内镜手术可有效缩短基底核区HICH患者的手术时间，减少术中出血量，提高血肿清除率，且安全性较好。

Abstract：

Objective To compare the effect of endoscopic neurosurgery and microscopic craniotomy in the treatmentof hypertensive intracerebral hemorrhage (HICH) in basal ganglia. Methods A total of 188 patients with HICH in basal gangliawho received surgical treatment in the Department of Neurosurgery of Zhangjiakou First Hospital from March 2017 to March 2022were retrospectively selected as the study objects. According to the different surgical methods, the patients were divided intoneuroendoscopy group (95 cases) and microscope group (93 cases) . The patients in the microscope group underwent microscopiccraniotomy, and the patients in the neuroendoscope group underwent endoscopic neurosurgery. Baseline data, operation-relatedindexes (operation time, intraoperative blood loss, hematoma clearance rate, incidence of postoperative intracranial infection) andthe proportion of good prognosis were compared between the two groups. Results The operative time of neuroendoscopy groupwas shorter than that of microscope group, the intraoperative blood loss was less than that of microscope group, and the clearancerate of hematoma was higher than that of microscope group (P < 0.05) . There was no significant difference in the incidence ofpostoperative intracranial infection between the two groups (P > 0.05). There was no significant difference in the proportion of goodprognosis between the two groups (P > 0.05) . Conclusion Compared with microscopic craniotomy, endoscopic neurosurgery caneffectively shorten the operation time of patients with HICH in basal ganglia, reduce the amount of intraoperative blood loss, andimprove the clearance rate of hematoma, with better safety.

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