神经导航定向内窥镜下微创治疗高血压脑出血  

Minimally invasive operation on hypertensive intracerebral hemorrhage patients under neuroendoscope and neuronavigation

作　　者：赵鸿[1] 钱忠心[1] 刘卫东[1] 毛青[1] 叶树铭[1] 龚良[1] 刘向阳[1] 丁勇[1] 彭毅华[1] 孙伟[1] 

机构地区：[1]上海市浦南医院神经外科,200125

出　　处：《临床神经外科杂志》2008年第2期91-93,共3页Journal of Clinical Neurosurgery

摘　　要：目的探讨神经内窥镜及导航系统在高血压脑出血手术中的应用。方法对25例高血压脑出血患者采取在神经导航引导、内窥镜辅助下行血肿穿刺清除治疗,并予以尿激酶灌注引流残余血肿,随访6个月,对治疗结果以KPS评分进行评价。结果本组25例患者血肿量20～40ml9例;40～60ml16例。术后即刻复查CT血肿清除率在30%～70%16例;大于70%9例。治疗后6个月KPS评分80～100分14例;60～70分8例;30～50分2例;1例死亡。结论神经导航引导、内窥镜辅助下行血肿穿刺清除,辅以尿激酶灌注引流治疗高血压脑出血,具有微创性、精确性、直视性、简便性、灵活性等优点,为高血压脑出血的治疗提供了良好的前景。Objective To investigate the application of neuroendoscope and neuronavigation in operation on hypertensive intracerebral hemorrhage （HICH） patients. Methods 25 patients with HICH were treated by hematoma puncture and drainage under navigation and endoscope. Results The volumes of hematoma between 20 - 40 ml was in 9 cases and 40 - 60 ml in 16 cases. Postopertive CT scan showed that hematoma evacuated rate between 30% - 50% was reached in 7 cases; 50% - 70% in 9 cases and 〉 70% in 9 cases. Following up for 1 - 6 months, the result of KPS was： 80 - 100 score in 14 cases ;60 -70 score in 8 cases ;30 - 50 score in 2 cases and 1 patient died. Conclusions Endoscope-assisted hematoma puncture and drainage under neural navigation followed by urokinase injection shows advantages such as minimal invasion, more accuracy, more convenient, etc, and provides good treatment for HCH patients.

关 键 词：高血压脑出血 神经内窥镜 神经导航 微侵袭 

分 类 号：R743.34[医药卫生—神经病学与精神病学]