摘要
目的观察应用神经内镜微创治疗脑室出血的效果。方法应用神经内镜微创技术治疗脑室出血20例,另以侧脑室外引流加尿激酶注入溶解血肿22例作为对照组,进行比较。结果术后24 h复查头颅CT,神经内镜手术组脑室内血肿绝大部分清除者16例,4例部分清除;术后颅内感染1例;无继发出血;术后2个月GOS评分,5分5例,4分8例,3分3例,2分2例,1分2例。对照组仅2例脑室内血肿大部分清除,余20例与术前无明显变化;继发出血1例;术后颅内感染5例;术后2个月GOS评分,5分2例,4分5例,3分8例,2分5例,1分2例。神经内镜手术组与对照组比较,术后血肿清除率及好转优良率高,差异有统计学意义(P<0.05);颅内感染、继发出血、病死率差异无统计学意义(P>0.05)。结论应用神经内镜微创技术清除脑室内血肿,具有直视下操作、术后疗效好等优点,是脑室出血较佳的外科治疗方法。
Objective To evaluate the new approach of minimal invasive treatment of ventricular hemorrhage.Methods Neuroendoscopy was applied to treat 20 cases of ventricular hemorrhage.Twenty-two patients who were treated by ventricular drainage were taken as control.Results In the neuroendoscope treatment group,nearly compete evacuation of intraventricular hematoma was achieved in 16 cases,partial evacuation in 4 cases.Intracranial infection after surgery happened in 1 case,there was no secondary hemorrhage after surgery in all cases.All patients were followed up for two months.According to GOS,the outcome was excellent in 5 cases,good in 8 cases,fare in 3 cases,poor in 2 cases,death in 2 cases.In external ventricular drainage group,only 2 cases achieved partial evacuation of intraventricular hematoma and no change in 20 cases.Secondary hemorrhage after surgery in 1 case and intracranial infection in 5 cases.All patients were followed up for two months.According to GOS,the result was excellent in 2 case,good in 5 cases,fare in 8 cases,poor in 5 cases,death in 2 cases.More patients in the neuroendoscope treatment group showed good recovery after two months （P ＜ 0.05）.The difference between the two groups in mortality rate and secondary hemorrhage after surgery rate was not statistically significant （P ＞ 0.05）.Conclusion Neuroendoscopic neurosurgery for ventricular hemorrhage is a good surgical treatment approach because it is characterized by visualized manipulation,effective hemorrhage evacuation and excellent postoperative outcomes.
出处
《北京医学》
CAS
2013年第11期917-920,共4页
Beijing Medical Journal
关键词
神经内镜
脑室出血
微创手术
脑室外引流
Neuroendoscope
Ventricular hemorrhage
Minimally invasive surgery
Ventricular drainage
