神经内镜辅助显微镜下治疗重型脑干出血的疗效分析

Clinical effect of neuroendoscope-assisted microscopic therapy for severe brainstem hemorrhage

摘要:

目的 探讨神经内镜辅助显微镜下治疗重型脑干出血的临床疗效。方法 回顾分析我院2014年1月~2018年3月收治的98例重型脑干出血患者临床资料，根据治疗方法不同分为手术组（39例）和对照组（59例），评估两组患者治疗1周后格拉斯哥昏迷评分（GCS）评分、3个月后改良Rankin评分，以及有效率、死亡率、持续植物状态（PVS）生存率。结果 手术组与对照组在治疗1周后GCS评分（t=2.39，P=0.012）、3个月后改良Rankin评分（χ²=7.36，P=0.003）、有效率（χ²=8.27，P=0.001）、死亡率（χ²=-6.15，P=0.006）、PVS生存率（χ²=-5.43，P=0.014）组间比较结果，差异均有统计学意义（均P<0.05）。本研究结果显示：神经内镜辅助显微镜下治疗重型脑干出血的临床疗效优于保守治疗。结论 采用神经内镜辅助显微镜下治疗重型脑干出血，可以提高治疗有效率，降低死亡率、PVS生存率，最终改善患者预后。

Abstract:

Objective To investigate the clinical effect of treated neuroendoscope-assisted microscopic therapy for severe brainstem hemorrhage.Methods A retrospective analysis was performed for the clinical data of 98 patients with severe brainstem hemorrhage who were admitted to our hospital from January 2014 to March 2018. According to the treatment method, they were divided into surgery group with 39 patients and control group with 59 patients. The two groups were evaluated in terms of Glasgow Coma Scale (GCS) score at 1 week after treatment, modified Rankin score at 3 months after treatment, response rate, mortality rate, and persistent vegetative state (PVS) survival.Results There were significant differences between the surgery group and the control group in GCS score at 1 week after treatment (t=2.39, P=0.012), modified Rankin score at 3 months after treatment (χ²=7.36, P=0.003), response rate (χ²=8.27, P=0.001), mortality rate (χ²=-6.15, P=0.006), and PVS survival rate (χ²=-5.43, P=0.014). The results of this study showed that neuroendoscope-assisted microscopic therapy had a better clinical effect than conservative treatment in the treatment of severe brainstem hemorrhage.Conclusions In the treatment of severe brainstem hemorrhage, neuroendoscope-assisted microscopic therapy can effectively improve response rate, reduce mortality rate and PVS survival rate, and finally improve patients' prognosis.