神经内镜治疗高血压脑出血破入脑室的随机对照研究  

Endoscopic surgery for hypertensive cerebral hemorrhage with intraventricular hematoma,a randomized controlled trial

作　　者：段虎斌[1] 蒯东[1] 郝春艳[1] 刘跃亭[1] 刘虹[1] 吕虹[1] 朱永梅[1] 

机构地区：[1]山西医科大学第一医院,太原030001

出　　处：《中国急救复苏与灾害医学杂志》2007年第2期75-77,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家"十五"攻关计划"脑卒中的规范化外科治疗技术推广应用研究"(编号:2001BA703B16(B))

摘　　要：目的研究应用神经内镜治疗高血压脑出血破入脑室的疗效。方法94例高血压脑出血破入脑室的患者随机分为A组和B组。A组接受神经内镜脑室血肿清除术,B组接受脑室穿刺外引流术。结果A组33例,11例脑室内血肿完全清除,19例大部分清除,3例部分清除。术后2周GCS为(12.34±0.99),显著高于术前的GCS〔(10.21±1.24)分,P<0.0001〕。B组61例,17例大部分清除,44例部分清除。术后2周GCS为(11.04±1.25)分,显著高于术前评分〔(9.79±1.17)分,P<0.0001〕。随访2个月后,A组GOS为(13.04±1.35)分,显著高于B组〔(11.79±0.95)分,P<0.0001〕。结论神经内镜治疗高血压脑出血破入脑室较脑室穿刺外引流术并发症及后遗症相对较少,病人恢复较快,效果确切。Objective To investigate the efficacy of endoscopic surgery for hypertensive intraventricular hemorrhage.Methods Ninety-four patients hypertensive of cerebral hemorrhage with ventricular hematoma were randomly divided into 2 groups :Group A,n=33,21 males and 12 females,aged 53.09±9.84(37～72),undergoing neuroendoscopy;and Group B,n=61,40 males and 21 females,aged 55.78±10.71(34～77),operated with brain ventricle puncture and drainage.Results In Group A,intraventricular hematoma was completely removed in 11 cases,mostly removed in 19 cases,and partially removed in 3 cases.The intraventricular hematoma was absorbed completely in 27 cases.The clinical symptoms vanished in 15 cases.The GCS 2 weeks after the operation was(12.34±0.99),significantly higher than that before the operation〔(10.21±1.24),P<0.000〕.In Group B,the hematoma were mostly removed in 17 cases and partially removed in 44 cases.The GCS 2 weeks after the operation was(11.04±1.25),significantly higher than that before the operation〔(9.79±1.17),P<0.000 1〕.The follow-up 2 months after the operation,the GCS of Group A was(13.04±1.35),significantly higher than that of Group B〔(11.79±0.95),P<0.000 1〕.Conclusion Endoscopic surgery is effective in the treatment of hypertensive cerebral hemorrhage with ventricular hematoma.

关 键 词：内镜 脑室穿刺 手术 高血压脑出血 脑室出血 随机对照 

分 类 号：R[医药卫生]