标题：神经内镜与立体定向手术治疗中少量高血压脑出血的效果比较

      作者：罗鹏，钱东翔，王智坚    (广州医科大学附属第三医院神经外科，广东 广州 510150)

      卷次： 2018年29卷11期

      【摘要】 目的 比较神经内镜手术与立体定向穿刺引流两种方法治疗中少量高血压脑出血的临床疗效。方法 回顾性分析广州医科大学附属第三医院神经外科2013年6月至2017年6月期间收治的72例中少量高血压脑出血患者的临床资料，其中28例患者接受神经内镜手术治疗(神经内镜组)，44例患者接受立体定向穿刺引流(立体定向组)，比较两种方法的血肿清除率、术后再出血率以及患者的平均住院时间的差异；术后随访3个月，观察两组患者的日常生活能力(ADL)评分。结果 神经内镜组患者在血肿清除率、再出血率和平均住院时间分别为(84.75±7.9)%、3.57%和(9.52±4.35) d，均明显优于立体定向组的(61.45±9.85)%、22.73%和(14.12±6.52) d，差异均有统计学意义(P<0.05)；神经内镜组患者术后 3个月的ADL评分中的总有效率为 92.86%，明显优于立体定向组的70.45%，差异有统计学意义(P<0.05)。结论 神经内镜手术治疗中少量高血压脑出血较立体定向穿刺引流更为高效和安全，值得临床上推广。
      【关键词】 高血压脑出血；神经内镜；立体定向穿刺引流；疗效
      【中图分类号】 R743.34 【文献标识码】 A 【文章编号】 1003—6350（2018）11—1600—04

Comparison of neuroendoscopic surgery and stereotatic puncture drainage in management of a small amount ofhypertensive intracerebral hemorrhage.
LUO Peng, QIAN Dong-xiang, WANG Zhi-jian. Department of Neurosurgery,the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong, CHINA
【Abstract】 Objective To compare the therapeutic effects of nureoendoscopic surgery and stereotatic puncturedrainage in the treatment of a small amount of hypertensive intracerebral hemorrhage (HICH). Methods The clinicaldata of 72 HICH patients treated between June 2013 and June 2017 in the Third Affiliated Hospital of Guangzhou Medi-cal University were analyzed, including 28 patients undergoing nureoendoscopic surgery (neuroendoscopy group) and 44patients undergoing stereotatic puncture drainage (stereotatic group). The rate of hematoma clearance, recurrence afteroperation, and the average length of hospital stay were compared between the two groups. All patients were followed upfor 3 months, and the ADL scores of the patients were observed. Results The rate of hematoma clearance, recurrencerate after operation, and the average length of hospital stay were (84.75±7.95)%, 3.57%, (9.52±4.35) d in neuroendosco-py group, versus (61.45±9.85)%, 22.73%, (14.12±6.52) d in stereotatic group (P<0.05). The total effective rate in ADLscore of neuroendoscopy group (92.86%) was significantly better than that in the stereotatic group (70.45%), P<0.05.Conclusion It is more effective and safer to treat the HICH patients by neuroendoscopic surgery than by stereotaticpuncture drainage, which is worth to be promoted in clinic.
      【Key words】 Hypertensive intracerebral hemorrhage; Neuroendoscopic; Stereotatic puncture drainage; Curativeeffect·临床经验·doi:10.3969/j.issn.1003-6350.2018.11.037