【摘要】 目的 分析比较神经导航辅助下内镜和显微镜治疗高血压脑出血(HCH)的临床效果。方法 选取2020-01—2021-01广东珠海市人民医院收治的68例HCH患者作为研究对象，按照手术方案分为内镜组与显微镜组，各34例。内镜组行神经导航辅助下内镜血肿清除术，显微镜组行显微镜辅助开颅血肿清除术。比较2组的手术时间、切口长度、术中出血量、住院时间、血肿清除率，以及术前、术后12周中国卒中神经功能缺损程度评分(CSS)、美国国立卫生院卒中量表(NIHSS)评分和术后并发症发生率。结果 内镜组的手术时间、切口长度、术后出血量、住院时间、血肿清除率均优于显微镜组，差异有统计学意义(P<0.05)。术前2组CSS评分、NIHSS评分的差异无统计学意义(P > 0.05)，术后12周内镜组的CSS评分、NIHSS评分均低于显微镜组，差异有统计学意义(P<0.05)。内镜组并发症发生率低于显微镜组，差异有统计学意义(P<0.05)。结论 与显微镜辅助开颅血肿清除术比较，神经导航辅助下内镜血肿清除术治疗HCH患者，可减轻手术创伤，术中出血量少，血肿清除率高，有利于神经功能恢复，且安全性更高。更多还原

【Abstract】 Objective To analyze and compare the clinical outcomes of endoscopic and microsurgical treatment for hypertensive intracerebral hemorrhage( HCH) under neuro-navigation assistance. Methods A total of 68 HCH patients from our hospital between January 2020 and January 2021 were selected,divided into an endoscopic group( n = 34) and a microsurgical group( n = 34) according to their surgical plans. The endoscopic group underwent endoscopic hematoma evacuation with neuro-navigation assistance,while the microsurgical group underwent microsurgical craniotomy with hematoma evacuation. The differences in surgery time,incision length,blood loss,hospital stay,hematoma clearance rate,preoperative and postoperative 12-week Chinese Stroke Neurological Deficit Scale( CSS) scores,National Institutes of Health Stroke Scale( NIHSS) scores,and postoperative complications were compared between the two groups. Results The endoscopic group had shorter surgery time,shorter incision length,less blood loss,shorter hospital stay,and higher hematoma clearance rate compared to the microsurgical group,with statistically significant differences( P < 0. 05). Preoperatively,there was no statistically significant difference in CSS or NIHSS scores between the two groups( P > 0. 05),but postoperatively,the endoscopic group had lower CSS and NIHSS scores compared to that of the microsurgical group,with statistically significant differences( P < 0. 05). The endoscopic group showed a significantly lower complication rate than the microscopic group( P < 0. 05). Conclusion Compared to microsurgical craniotomy with hematoma evacuation,endoscopic hematoma evacuation with neuro-navigation assistance can reduce surgical trauma,minimize surgical bleeding,effectively clear hematomas,promote patient neurological recovery,and offer greater safety.更多还原