硬性神经内镜术与传统钻孔冲洗引流术治疗慢性硬膜下血肿的临床效果
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陕西省科学技术研究发展计划项目(2015SF014);


Clinical effect of rigid neuroendoscopy and traditional drilling irrigation and drainage in treating chronic subdural hematoma
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    摘要:

    目的:探讨硬性神经内镜术与传统钻孔冲洗引流术治疗慢性硬膜下血肿(CSDH)的临床效果。方法:回顾性分析CSDH患者的临床资料,依据治疗方法不同分为传统组(传统钻孔冲洗引流术治疗)和内镜组(硬性神经内镜术治疗),每组各48例。比较两组患者围手术期指标,GCS评分,Markwalder分级及NIHSS评分差异,统计两组并发症发生情况及复发率。结果:内镜组患者术中出血量、住院时间、术后即刻血肿清除率优于传统组(P<0.05),传统组患者总手术时间短于内镜组(P<0.05);术后7 d,两组患者GCS评分和Markwalder神经功能分级均改善(P<0.05),但两组无统计学差异(P>0.05);术后不同时间点两组患者的NIHSS评分均降低(P<0.05),且内镜组低于传统组(P<0.05);两组患者并发症总发生率无统计学差异(P>0.05),内镜组血肿复发率低于传统组(P<0.05)。结论:硬性神经内镜术与传统钻孔冲洗引流术均能有效治疗CSDH且神经内镜术后血肿清除率更高,住院时间短,术后复发率更低,值得临床推广。

    Abstract:

    Objective:To explore the clinical effect of rigid neuroendoscopy and traditional drilling irrigation and drainage in the treatment of chronic subdural hematoma(CSDH).Methods:The clinical data of CSDH patients were retrospectively analyzed.Accord-ing to different treatment methods,they were divided into traditional group(treated with traditional drilling irrigation and drainage)and endoscopic group(treated with rigid neuroendoscopy),48 cases in each group.The differences in perioperative indicators,GCS score,Markwalder grading and NIHSS score were compared between groups,and the complications and recurrence rate in the two groups were counted.Results:The intraoperative blood loss,hospitalization time and immediate postoperative hematoma clearance rate in endoscopic group were better than those in traditional group(P<0.05),and the total surgical time in traditional group was shorter than that in en-doscopic group(P<0.05).At 7 days after surgery,the GCS score and Markwalder neurological function grading in the two groups were improved(P<0.05),but there were no obvious differences between the two groups(P>0.05).Different time points after surgery,the NIHSS score in both groups was reduced compared to before surgery(P<0.05),and the score was lower in endoscopic group than that in traditional group(P<0.05).The complications showed no significant differences(P>0.05),and the recurrence rate of hematoma was lower than that in traditional group(P<0.05).Conclusion:Both rigid neuroendoscopy and traditional drilling irrigation and drainage can effectively treat CSDH,but neuroendoscopy has higher hematoma clearance rate,shorter hospitalization time and lower postoperative recurrence rate,which is worthy of clinical promotion.

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董西朝;王凤鹿;赵海康;荣波;.硬性神经内镜术与传统钻孔冲洗引流术治疗慢性硬膜下血肿的临床效果[J].川北医学院学报,2025,40(6):736-739.

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  • 在线发布日期: 2025-07-09
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