简介:摘要:目的:探究三叉神经微血管减压术围手术期护理在患者康复中的应用。方法:选取医院2021年1月-2021年12月收治76例行三叉神经微血管减压术患者,随机分组A组、B组,各38例,A组-常规护理,B组-围手术期护理,观察两组患者术后并发症以及生活质量。结果:B组患者术后并发症发生率低于A组,术后生活质量评分高于A组(P
简介:摘要目的探讨神经内镜手术与小骨瓣开颅手术治疗高血压脑出血的临床效果,并分析其对神经功能的影响。方法收集医院神经外科2014年1月到2017年12月间110例高血压脑出血患者作为研究对象,将其按照不同手术治疗方法分为神经内镜手术组(n=57例)和小骨瓣开颅手术组(n=53例),对两组临床治疗效果和神经功能状况进行观察。结果神经内镜手术组患者的手术时间和术中出血量以及住院时间均明显的低于小骨瓣开颅手术组,而血肿清除率高于小骨瓣开颅手术组,手术后两组患者GCS评分和NIHSS评分均较手术前明显的改善,且神经内镜手术组改善程度优于小骨瓣开颅手术组,组间数据差异有统计学意义(P<0.05)。结论临床中对于高血压脑出血患者应用神经内镜手术治疗效果优于小骨瓣开颅手术,血肿清除率高,手术时间短,并更好的改善神经功能恢复,临床应用价值高。
简介: 【摘要】 目的:对比神经内镜与显微镜经鼻蝶手术治疗垂体瘤的临床效果。方法:选取 2018年 1月 -2019年 12月 本院收治并接受手术治疗的垂体瘤患者51例,按手术方法不同分为对照组( n=21)和观察组( n=30)。对照组应用经鼻蝶显微镜垂体瘤切除术,观察组应用经鼻蝶神经内镜垂体瘤切除术。观察并比较两组手术情况、肿瘤全切除率、手术前后的视觉功能、激素水平及并發症发生情况。结果:观察组手术时间、术中出血量和总住院时间均明显少于对照组( P<0.05) ;观察组肿瘤全切除率( 95.24%)明显高于对照组( 73.33%),差异有统计学意义( P<0.05) ;手术后,两组加权视野指数高于治疗前,而视野平均缺损和模式标准差均低于手术前( P<0.05)。观察组加权视野指数、视野平均缺损和模式标准差均优于对照组( P<0.05)。手术后,两组泌乳素、生长激素和促肾上腺皮质激素均低于手术前( P<0.05) ;观察组泌乳素、生长激素和促肾上腺皮质激素均低于对照组( P<0.05) ;观察组并发症发生率( 10.00%)低于对照组( 38.10%),差异有统计学意义( P<0.05)。结论:对于垂体瘤患者,神经内镜经鼻蝶手术治疗效果优于显微镜经鼻蝶手术,可显著提高肿瘤全切除率,促进患者视觉功能的恢复,降低激素水平,值得临床推广应用。 【关键词】 经鼻蝶显微镜垂体瘤切除术 经鼻蝶神经内镜垂体瘤切除术 垂体瘤 [Abstract] Objective: To compare the clinical effect of endoscopic and microscopical transsphenoidal surgery for pituitary tumor. Methods: from January 2018 to December 2019, 51 patients with pituitary tumor who were treated by surgery were divided into control group (n = 21) and observation group (n = 30). The control group was treated with transsphenoidal microsurgery and the observation group with transsphenoidal neuroendoscopic surgery. To observe and compare the operation condition, total tumor resection rate, visual function before and after operation, hormone level and complications between the two groups. Results: the operation time, intraoperative blood loss and total hospitalization time of the observation group were significantly shorter than those of the control group (P < 0.05); the total tumor resection rate of the observation group (95.24%) was significantly higher than that of the control group (73.33%), the difference was statistically significant (P < 0.05); after operation, the weighted visual field index of the two groups was higher than that before treatment, while the average visual field defect and mode standard deviation were lower than that before operation (P < 0.05). The weighted visual field index, average visual field defect and mode standard deviation of the observation group were all better than those of the control group (P < 0.05). After operation, prolactin, growth hormone and adrenocorticotropic hormone in the two groups were lower than those before operation (P < 0.05); prolactin, growth hormone and adrenocorticotropic hormone in the observation group were lower than those in the control group (P < 0.05); the incidence of complications in the observation group (10.00%) was lower than that in the control group (38.10%), the difference was statistically significant (P < 0.05). Conclusion: neuroendoscopic transsphenoidal surgery is better than microscopical transsphenoidal surgery in the treatment of pituitary tumor, which can significantly improve the total tumor resection rate, promote the recovery of visual function of patients, and reduce the level of hormone. It is worthy of clinical application.
简介:目的探讨耳内镜下进行听骨链重建术的可行性。方法对1998年5月至2011年2月应用耳内镜(直径2.7mm,视角为0°或30°)行听骨链重建的52例病人进行回顾性分析,并对其近期疗效初步评估。结果52例患者全部顺利在耳内镜下完成手术,其中耳硬化症25例,鼓室硬化症19例,听骨链部分缺损8例。耳硬化症患者4例采用镫骨底板部分切除,21例采用小窗技术,7例无需外道后上壁盾板切除,即可在内镜下完成手术。鼓室硬化症8例去除病灶行镫骨撼动,11例切除砧骨及镫骨上结构,采用TORP或Piston进行听骨链重建。听骨链部分缺损采用TORP或PORP人工听骨连接,重建听骨链。经随访6个月以上的病例有40例,其中35例术后听力有明显改善,骨气导差在15dB以内,近期疗效满意。结论根据初步临床应用观察,认为耳内镜可以用于听骨链重建手术,尤其是耳硬化症患者。其优点是创伤小,恢复快,缺点是耳内镜下进行单手精细操作有一定难度,对于外耳道狭窄者不适宜。