微创医学

目的比较内镜辅助小骨窗开颅术与微创颅内血肿清除术对高血压脑出血患者的疗效及其血浆内皮素(ET)水平的影响。方法将70例高血压脑出血患者随机分成治疗组和对照组,对照组采用内镜辅助小骨窗开颅术治疗,治疗组采用微创血肿清除术治疗。于治疗前、治疗第14天、治疗后第30天记录并对比两组的神经功能缺损程度评分及综合临床疗效;治疗后3 d、7 d、14 d分别检测血浆ET含量,并进行对比。结果治疗14 d和30 d后,治疗组神经功能缺损程度评分及综合疗效均优于对照组,差异有统计学意义(P<0.05)。治疗组治疗后3 d、7 d、14 d血浆ET含量均显著低于对照组(P<0.01)。结论脑出血患者采用内镜辅助小骨窗开颅术,可有效地促进神经功能康复,提高临床疗效。

Objective To compare the therapeutic effect on hypertensive cerebral hemorrhage between endoscopic small bone window craniotomy and minimally invasive surgery and their influences on plasma endothelin levels． Methods 70 patients of hypertensive cerebral hemorrhage were randomly divided into treatment group，treated with endoscopic small bone window craniotomy，and control group，treated with minimally invasive removal of hematoma． Neurologic deficit scores and integrated clinical efficacy of the two groups were compared before treatment and 14d and 30d after． Plasma ET levels were measured and compared 3d，7 d， and 14d after treatment． Results 14d and 30d after treatment，neurologic deficit scores and integrated clinical efficacy of the treatment group were superior than those of the control group，all with statistical significance ( P ＜ 0． 05) ． And plasma endothelin level in the treatment group was significantly lower than in the control group 3d，7 d，and 14d after treatment ( P ＜ 0． 01) ． Conclusion Endoscopic small bone window craniotomy can promote neurofunctional rehabilitation，and improve clinical effect in patients with hypertensive cerebral hemorrhage．

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