摘要
目的探讨神经内镜下小骨窗手术治疗急性硬膜外血肿的可行性。方法回顾性选取2022年1月—2024年1月阿克苏地区第二人民医院神经外科收治的100例急性硬膜外血肿的临床资料。根据治疗方式分为对照组和研究组,对照组采用常规开颅手术(n=50),研究组采用神经内镜下手术(n=50)。对比两组术后血肿清除率、72 h出血率、术后卧床时间、手术时间、术后脑受压下降情况及脑中线变化、意识状况改善情况、不良反应发生情况。结果研究组术后血肿清除率为(95.15±1.45)%,高于对照组的(91.28±1.34)%,差异有统计学意义(t=13.860,P<0.05)。研究组72 h出血率低于对照组,差异有统计学意义(P<0.05)。研究组术后卧床时间、手术时间均短于对照组,差异均有统计学意义(P均<0.05)。研究组术后(6、24、72 h)脑受压下降情况及术后脑中线变化情况均优于对照组,差异均有统计学意义(P均<0.05)。研究组术后意识状况改善情况优于对照组,差异均有统计学意义(P均<0.05)。研究组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论神经内镜下小骨窗手术治疗急性硬膜外血肿可显著提高血肿清除率,缩短手术时间及卧床时间,并促进脑受压及中线结构恢复,临床疗效优于传统开颅手术。该术式具有微创、恢复快等优势,尤其适用于远隔静脉窦的硬膜外血肿患者。
Objective To explore the feasibility of small bone window surgery under neuroendoscopy in the treatment of acute epidural hematoma.Methods The clinical data of 100 patients with acute epidural hematoma admitted to the Department of Neurosurgery of The Second People′s Hospital of Aksu Prefecture from January 2022 to January 2024 were retrospectively selected.According to the treatment methods,they were divided into control group and study group.The control group was treated with conventional craniotomy(n=50),and the study group was treated with neuro-endoscopic surgery(n=50).The postoperative hematoma clearance rate,72 h bleeding rate,postoperative bed rest time,operation time,postoperative brain compression decline,brain midline change,consciousness improvement and the occurrence of adverse reactions were compared between the two groups.Results The postoperative hematoma clearance rate of the study group was(95.15±1.45)%,which was higher than(91.28±1.34)%of the control group,and the difference was statistically significant(t=13.860,P<0.05).The 72 h bleeding rate of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).The postoperative bed rest time and operation time of the study group were shorter than those of the control group,and the differences were statisti-cally significant(all P<0.05).The decrease of brain compression at 6,24 and 72 h after operation and the change of brain midline after operation in the study group were better than those in the control group,and the differences were statistically significant(all P<0.05).The improvement of postoperative consciousness in the study group was better than that in the control group,and the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Neuroendoscopic small bone window surgery for acute epidural hematoma can significantly im-prove the hematoma clearance rate,shorten the operation time and bed rest time,and promote the recovery of brain compression and midline structure.The clinical efficacy is better than that of traditional craniotomy.This operation has the advantages of minimally invasive and rapid recovery,and is especially suitable for patients with epidural he-matoma in remote venous sinus.
作者
刘喜文
艾孜买提·那斯尔
居热艾提·艾亥提
宋西强
徐文安
陈建
LIU Xiwen;Aizimaiti Nasier;Jureaiti Aihaiti;SONG Xiqiang;XU Wen´an;CHEN Jian(Department of Neurosurgery,The Second People′s Hospital of Aksu Prefecture,Aksu 843000,Xinjiang Uygur Autonomous Region,China;Kuitun Hospital of Ili Kazakh Autonomous Prefecture,Xinjiang,Kuitun 833200,Xinjiang Uygur Autonomous Region,China)
出处
《系统医学》
2025年第12期131-134,146,共5页
Systems Medicine
关键词
颅脑损伤
硬膜外血肿
颅内高压
神经内镜
静脉窦
再出血
Traumatic brain injury
Epidural hematoma
Intracranial hypertension
Neuroendoscopy
Venous sinus
Bleeding again
