Efficacy of endoscopic minimally invasive surgery combined with tube aspiration for intracerebral hemorrhage

doi:10.3877/cma.j.issn.2095-9141.2018.06.007

Abstract

Abstract:

Objective

To analyze the clinical efficacy of neuroendoscopic microtrauma combined with catheter aspiration in the treatment of cerebral hemorrhage.

Methods

A total of 100 patients with cerebral hemorrhage, admitted to the Department of Neurosurgery, the First Affiliated Hospital of Chengdu Medical College from January 2015 to January 2018, were selected and divided into the observation group and the control group according to the random envelope method. The control group was treated with neuroendoscopic minimally invasive technology, while the observation group was treated with neuroendoscopic minimally invasive surgery combined with catheter aspiration. The neurological function of the patients before and 30 d after treatment was evaluated by NIHSS. The levels of hypersensitive c-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) were recorded before and 3 months after treatment. Comparing the incidence of complications and the clearance rate of hematoma 24 h after operation between the 2 groups, the total effective rate of treatment was recorded after half a year follow-up.

Results

The total effective rate of the observation group was higher than that of the control group, with statistical significance (P<0.05); the clearance rate of hematoma in the observation group was higher than that in the control group at 24 h, and the incidence of re-bleeding and electrolyte disturbance was lower than that in the control group, with statistical significance (P<0.05). However, there was no significant difference in the incidence of intracranial infection between the two groups (P>0.05). After treatment, the NIHSS score of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of TNF-α, hs-CRP and IL-6 in the observation group were lower than those in the control group, with statistical significance (P<0.05).

Conclusion

Neuroendoscopic microtrauma combined with catheter aspiration can effectively improve the clinical efficacy, reduce the incidence of adverse reactions and improve the prognosis of patients with intracerebral hemorrhage.

Key words: Cerebral hemorrhage, Neuroendoscopic microtrauma, Catheter aspiration

Jie Zhang, Enren Wang, Lie Zhang, Haibo Liu. Efficacy of endoscopic minimally invasive surgery combined with tube aspiration for intracerebral hemorrhage[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2018, 04(06): 344-348.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsjcswkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9141.2018.06.007

https://zhsjcswkdzzz.cma-cmc.com.cn/EN/Y2018/V04/I06/344

Figures/Tables 4

References 23

[1]	Cai RZ, Wang YQ, Wang R, et al. Microscope-assisted anterior cervical discectomy and fusion combined with posterior minimally invasive surgery through tubular retractors for multisegmental cervical spondylotic myelopathy: a retrospective study[J]. Medicine, 2017, 96(35):e7965.
[2]	李涵，郝东宁，马肃.神经导航辅助微创手术治疗老年高血压性基底节出血的临床疗效[J].卒中与神经疾病, 2018, 25(1):64-67.
[3]	张盼盼.微创手术联合置管吸引手术对老年脑出血患者愈合影响探析[J].中国老年保健医学, 2016, 14(3):68-69.
[4]	张圣旭，郭自强，宋振,等.微创手术合置管吸引治疗脑出血的疗效及对神经功能的影响[J].实用中西医结合临床, 2018, 3(5):12-15.
[5]	廖英姣.微创置管吸引术治疗高血压脑出血的手术配合[J].华夏医学, 2004, 17(1):105-106.
[6]	陆敏，张静.急性脑损伤患者熵指数与格拉斯哥昏迷评分的相关性研究[J].中华危重病急救医学, 2018, 30(1):47-50.
[7]	王大力，彭延波，邢磊,等. NIHSS评分在急性脑梗死患者中的应用与回归方程的建立[J].华北理工大学学报(医学版), 2007, 9(3):297-298.
[8]	Zhang J, Lu S, Wang S, et al. Comparison and analysis of the efficacy and safety of minimally invasive surgery and craniotomy in the treatment of hypertensive intracerebral hemorrhage[J]. Pak J Med Sci, 2018, 34(3):578-582.
[9]	Hanley DF, Thompson RE, Muschelli J, et al. Safety and efficacy of minimally invasive surgery plus alteplase in intracerebral haemorrhage evacuation (MISTIE): a randomised, controlled, open-label, phase 2 trial[J]. Lancet Neurol, 2016, 15(12):1228-1237.
[10]	吕超，费舟，胡学安,等.低频重复经颅磁刺激对颅脑损伤后植物状态患者的促醒作用[J].中国医药导报, 2016, 13(17):69-72.
[11]	Milone M, Fernandez L M, Musella M, et al. Safety and efficacy of minimally invasive video-assisted ablation of pilonidal sinus: a randomized clinical trial[J]. JAMA Surg, 2016, 151(6):547-553.
[12]	Saki ZI, Kallidonis P, Kotsiris D, et al. P59-investigation of the artery sealing efficacy of newly introduced polymeric clips for minimally invasive surgery: an in vivo study[J]. Eur Urol Suppl, 2018, 17(4):e2088.
[13]	于洋，熊楠楠，李洪,等.微创介入治疗在隧道式带涤纶套透析导管嵌顿的血液透析患者中的临床应用价值[J].中华肾脏病杂志, 2017, 33(11):838-842.
[14]	吴德权，邵君飞，戴敏超.神经导航下精准置管治疗中等量基底节区脑出血患者的疗效观察[J].江苏医药, 2017, 43(10):738-739.
[15]	Wang MY, Grossman J. Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up[J]. Neurosurg Focus, 2016, 40(2):E13.
[16]	Le W, Zhou W, Li C，et al. A preliminary clinical study of endoscopic minimally-invasive surgery in urethral stricture complicated with false passage[J]. Springerplus, 2016, 5(1):1457.
[17]	De Gregorio A, Pedrotti E, Russo L, et al. Minimally invasive combined glaucoma and cataract surgery: clinical results of the smallest ab interno gel stent[J]. Int Ophthalmol, 2018, 38(3):1129-1134.
[18]	Wysong A, Taylor BR, Graves M, et al. Successful treatment of chronic venous ulcers with a 1,320-nm endovenous laser combined with other minimally invasive venous procedures[J]. Dermatol Surg, 2016, 42(8):961-966.
[19]	葛新，陈晓雷，孙吉庆,等.简易导航下神经内镜经kocher点额中回入路微创手术治疗丘脑出血破入脑室[J].中国神经精神疾病杂志, 2017, 43(3):176-179.
[20]	Kamel MK, Rahouma M, Ghaly G, et al. Clinical predictors of persistent mediastinal nodal disease after induction therapy for stage iiia n2 non-small cell lung cancer[J]. Ann Thorac Surg, 2017, 103(1):281-286.
[21]	尹晓亮，张锟，张智敏,等.影响高血压性脑出血患者手术治疗预后的多因素分析[J].卒中与神经疾病, 2008, 15(4):224-226.
[22]	Kobara H, Mori H, Masaki T. A gastric duplication cyst with heterotopic pancreas and ectopic submucosal gland on submucosal endoscopy[J]. Dig Endosc, 2016, 28(2):223.
[23]	Scheltema MJ, van den Bos W, de Bruin DM, et al. Focal vs extended ablation in localized prostate cancer with irreversible electroporation; a multi-center randomized controlled trial[J]. BMC Cancer, 2016, 16(1):299.

组别	例数	治愈	有效	无效	有效率（%）
观察组	50	31	14	5	45（90.00）
对照组	50	23	13	14	36（72.00）
χ²值	?	?	?	?	5.263
P值	?	?	?	?	0.022

组别	例数	治愈	有效	无效	有效率（%）
观察组	50	31	14	5	45（90.00）
对照组	50	23	13	14	36（72.00）
χ²值	?	?	?	?	5.263
P值	?	?	?	?	0.022

组别	24 h血肿清除率	术后并发症
组别	24 h血肿清除率	再次出血	电解质紊乱	颅内感染
观察组	43（86.00）	3（6.00）	4（8.00）	2（4.00）
对照组	34（68.00）	8（16.00）	10（20.00）	3（6.00）
χ²值	8.346	5.107	5.980	0.421
P值	0.001	0.024	0.015	0.516

组别	24 h血肿清除率	术后并发症
组别	24 h血肿清除率	再次出血	电解质紊乱	颅内感染
观察组	43（86.00）	3（6.00）	4（8.00）	2（4.00）
对照组	34（68.00）	8（16.00）	10（20.00）	3（6.00）
χ²值	8.346	5.107	5.980	0.421
P值	0.001	0.024	0.015	0.516

组别	治疗前	治疗后	t值	P值
观察组	45.83±7.29	8.29±1.10	36.005	0.001
对照组	44.05±8.17	13.29±2.07	25.807	0.001
t值	1.120	15.083	?	?
P值	0.266	0.001	?	?

Please choose a citation manager

Content to export