可固定透明神经内镜鞘下双吸引技术治疗高血压性脑出血  

Double-channel suction technique under sheath using transparent neuroendoscope for hypertensive cerebral hemorrhage

作　　者：陆华[1] 朱爱华[1] 吴春富[1] 吴卫江[1] 房文峰[1] 葛风[1] 徐杰[1] 陈革[1] 周建宏[1] 蒋云召[1] 陆爻忠[1] 王泳[1] 

机构地区：[1]无锡市第三人民医院神经外科,214041

出　　处：《中国微侵袭神经外科杂志》2011年第8期353-355,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨透明神经内镜鞘下双吸引技术治疗高血压性脑出血的应用价值。方法回顾性分析26例高血压性脑出血病人的临床资料,其中基底核区脑出血19例,脑室出血7例。设计可固定透明神经内镜鞘、固定装置和内镜吸引器,均采用可固定透明神经内镜鞘下双吸引技术。结果 26例病人头皮平均切口长度3.5 cm(3～4 cm),骨窗直径1.8 cm(1.5～2.5 cm),术中平均失血量55 ml(30～100 ml),平均手术时间60 min(40～150 min)。术后1 d头部CT复查显示平均血肿清除率90%(70%～95%)。术后6个月GOS评分:恢复良好3例,轻度残疾14例,重度残疾6例,植物生存2例,死亡1例。结论透明神经内镜鞘及固定装置可为内镜提供一个清晰、稳定的空气环境,采用双吸引技术使血肿清除、止血更有效。Objective To explore the application value of double-channel suction technique under sheath using transparent neuroendoscope in the treatment of hypertensive cerebral hemorrhage.Methods The clinical data of 26 patients with hypertensive cerebral hemorrhage were analyzed retrospectively,including 19 with cerebral hemorrhage in the basal ganglion and 7 with ventricular hemorrhage.The transparent neuroendoscope sheath,fixtures and endoscopic suction were designed.The double-channel suction technique via transparent neuroendoscope sheath was performed in all the patients.Results The length of scalp incision was 3 to 4 cm with a mean of 3.5 cm,the diameter of bone window was 1.5 to 2.5 cm with a mean of 1.8 cm,intraoperative blood loss was 30 to 100 ml with a mean of 55 ml,the operation time was 40 to 150 min with a mean of 60 min,the hematoma evacuation rate was 70% to 95% with a mean rate of 90% by head CT reexamination 1 d after the operation.The glasgow outcome scale（GOS） score 6 months after the operation revealed： recovered well in 3 patients,mild disability in 14,severe disability in 6,vegetative state in 2 and died in 1.Conclusions The transparent neuroendoscopic sheath and its fixtures can provide a clear and stable air environment for endoscopy.Using double-channel suction technique is more effective in evacuating hematomas and hemostasis.

关 键 词：颅内出血 高血压性 神经内镜 神经外科手术 

分 类 号：R651.1[医药卫生—外科学]