Objective To investigate the effects of the neural endoscopic minimally invasive surgery on complications and life quality of patients with hypertensive cerebral hemorrhage.Methods One hundred patients with hypertensive cerebral hemorrhage who were admitted and treated in our hospital from December 2012 to December 2016 were enrolled in the study. According to random number table,these patients were divided into endoscope group and craniotomy group, with 50 patients in each group.The patients in craniotomy group were treated by conventional craniotomy with small bone window to remove hematoma,however,the patients in endoscopy group were treated by neural endoscopic minimally invasive surgery to remove hematoma,with 6-month follow up for both groups. The nerve function of patients was assessed by national institutes of health stroke scale (NIHSS) scores,and the serum levels of endothelin (ET),C-reactive protein (CRP) and interleukin-6 (IL-6) were detected by enzyme-linked immunosorbent (ELISA),the life quality was evaluated by daily life ability scale (ADL), moreover,the intraoperative bleeding volume, surgical duration, postoperative ICU stay time, complications, death rate, neural function before and after treatment,serum levels of ET,CRP,IL-6,life quality before treatment and on 1m,3m,6m after treatment were statistically analyzed and compared between two groups.Results The effective rate in endoscope group was significantly higher than that in craniotomy group,and the NIHSS scores after treatment in the former were significantly lower than those in the latter (P <0.05). The serum levels of ET, CRP, IL-6 after treatment in endoscope group were significantly lower than those in craniotomy group (P <0. 05). The intraoperative bleeding volume, surgical duration, postoperative ICU stay time in endoscope group were significantly less than those in craniotomy group,and the hematoma clearance rate in the former was significantly higher than that in the latter(P<0.05). The incidence rates of complications in endoscope group were significantly lower than those in craniotomy group (P <0.05), however, there was no significant difference in death rate between two groups(P>0.05). The ADL scores on 1m,3m,6m after treatment in endoscope group were significantly higher than those in craniotomy group (P<0.05).Conclusion The neural endoscopic minimally invasive surgical treatment can effectively decrease the surgical trauma of patients with hypertensive cerebral hemorrhage and improve the effects of hematoma clearance,which can effectively improve the nerve function and endothelial function of patients,and relieve inflammation status,which is beneficial for body rehabilitation of patients, moreover,which can effectively reduce the risk of incidence of complications,and effectively improve life quality of patients,therefor,which is worth using widely in clinical practice.%目的 探讨神经内镜微创手术对高血压脑出血患者并发症及生活质量的影响.方法 选取2012年12月至2016年12月确诊治疗的高血压脑出血患者100例,依据随机数表法随机分为内镜组和开颅组,每组50例.开颅组患者给予常规小骨窗开颅术清除血肿治疗,内镜组患者给予神经内镜微创手术清除血肿治疗,随访6个月,采用美国国立卫生研究院卒中量表(NIHSS)评估神经功能,采用酶联免疫吸附法(ELISA)检测血浆内皮素(ET)、C-反应蛋白(CRP)、白介素(IL-6)水平,采用日常生活能力量表(ADL)评估生活质量,统计分析所有患者治疗疗效、术中出血量、手术、术后住ICU时间、并发症、死亡和治疗前后神经功能、血浆ET、CRP、IL-6水平及治疗前、治疗后1、3、6个月的生活质量情况.结果 内镜组患者治疗显效率明显高于开颅组,前者治疗后NIHSS得分明显低于后者,差异有统计学意义(P<0.05);内镜组患者治疗后ET、CRP、IL-6水平明显低于开颅组,差异有统计学意义(P<0.05);内镜组患者术中出血量、手术、术后住ICU时间明显低于开颅组,前者血肿清除率明显高于后者,差异有统计学意义(P<0.05);内镜组患者并发症发生率明显低于开颅组,差异有统计学意义(P<0.05),但2组患者死亡率基本相同,差异无统计学意义(P>0.05);内镜组患者治疗后1、3、6个月的 ADL 得分明显高于开颅组,差异有统计学意义(P <0.05).结论 神经内镜微创手术治疗可有效减少高血压脑出血患者的手术创伤和提高血肿清除效果,及可有效改善患者的神经功能、内皮功能及炎症状态,有利于患者术后身体康复和生存,并可降低并发症发生的风险,且可有效促进患者生活质量的恢复,值得临床作进一步推广.
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