摘要目的 探讨自制透明鞘管辅助前额锁孔入路神经内镜血肿清除术对基底节区脑出血(BGCH)患者术后血肿清除率及日常生活活动能力(ADL)评分的影响. 方法 选取2014年10月至2017年1月山西省大同市同煤集团总医院神经外科收治的104例BGCH患者,按照不同术式分为观察组与对照组,每组52例. 对对照组患者行传统开颅血肿清除术;对观察组患者行自制透明鞘管辅助前额锁孔入路神经内镜血肿清除术,对两组患者术后随访3个月. 比较两组患者的血肿清除率、术后3个月预后情况、术前及术后3个月ADL评分及生活质量评分. 结果 观察组患者的血肿清除情况优于对照组,差异有统计学意义(P<0.05);观察组患者术后3个月预后情况优于对照组,差异有统计学意义(P<0.05);观察组患者的术前ADL评分与对照组比较,差异无统计学意义(P>0.05),术后3个月但观察组患者的ADL评分高于对照组,差异有统计学意义(P<0.05);术前观察组躯体角色、情感职能、社会功能、精力、一般健康状况、精神健康、躯体疼痛、躯体机能分值与对照组比较,差异无统计学意义(P>0.05),术后3个月两组躯体角色、情感职能、社会功能、精力、一般健康状况、精神健康、躯体疼痛、躯体机能分值均较术前增高,且观察组患者的生活质量评分高于对照组,差异有统计学意义(P<0.05). 结论 自制透明鞘管辅助前额锁孔入路神经内镜血肿清除术治疗BGCH的血肿清除率高,有利于改善患者预后及日常生活活动能力.

abstractsObjective To investigate the effect of self-made transparent sheath-assisted forearm-locking approach on endoscopic hematoma evacuation on postoperative hematoma evacuation rate and daily living activity(ADL)score in patients with basal ganglia hemorrhage(BGCH).Methods A retrospective study was performed on 104 cases of patients with BGCH who were admitted from October 2014 to January 2017.According to different surgery methods,patients were divided into the observation group and the con-trol group,with 52 cases in each group.Patients in the control group were treated with traditional craniotomy and hematoma evacuation;the others in the observation group were treated with self-made transparent sheath-assisted forearm-locking approach,both groups were followed up for 3 months after operation.The he-matoma clearance rate,3 months postoperative prognosis,preoperative and postoperative 3 months ADL score and quality of life of the two groups were compared.Results The hematoma removal in the observa-tion group was superior to that in the control group(P<0.05);the prognosis of the observation group was better than that of the control group at 3 months after operation (P <0.05);compared with the control group,the ADL score of the observation group before the operation had no statistically significant difference(P>0.05),the ADL score of the observation group 3 months after the operation was higher than that in the control group(P<0.05).Before surgery,the physical role,emotional function,social function,vitality,gen-eral health,mental health,body pain and physical function scores of observation group were compared with the control group,and the difference was not statistical significant(P>0.05).Three months after surgery, physical role,emotional function,social function,vitality,general health status,mental health,body pain, physical function scores of two groups were higher than those before the surgery,and the score in the obser-vation group was higher than that in the control group,and the difference was statistically significant (P<0.05).Conclusion BGCH self-made transparent sheath assisted forearm keyhole approach neuroendo-scopic hematoma evacuation treatment,its hematoma clearance rate is high,which is conducive to improving the prognosis of patients and daily living activities.