神经内窥镜控制手术、小骨窗开颅手术与脑室穿刺尿激酶灌注引流治疗高血压脑室出血的对比观察  

Comparison of treatment effect on hypertension ventricular hemorrhage using endoscope-controlled operations, Burr-hole craniotomy and urokinase perfusion through ventricular puncture

作　　者：吕正文[1] 张明然[1] 李孟考[1] 

机构地区：[1]山东省泰安市中心医院神经外科,271000

出　　处：《中国综合临床》2011年第11期1192-1195,共4页Clinical Medicine of China

摘　　要：目的探讨神经内窥镜控制手术治疗高血压脑室出血的有效性和安全性。方法回顾分析神经内窥镜控制手术、小骨窗开颅手术，脑室穿刺尿激酶灌注引流三种方法治疗特定的脑出血破入脑室患者，并据此分组，比较手术疗效和并发症情况。结果神经内窥镜组分别与其他2组比较，术后并发症明显减少（x^2=9．966，P〈0．05）。32例应用神经内窥镜控制手术清除血肿的患者中术后死亡2俐，病死率6．25％；术后6个月ADL评分：I级2例，Ⅱ级14例；Ⅲ级11例；1V级3例，V级2例，与其他2组比较，差异有统计学意义（x^2=10．499，P〈0．05）。结论应用脑内窥镜控制下手术治疗脑出血破入脑室患者，具有脑组织再伤小，颅内血肿清除及时、彻底和术后并发症少等优点，是一种治疗高血压脑出血破人陆室帛者害全右特的治疗青法．Objective To investigate the efficacy, safety and practicability of endoscope-controlled microneurosurgery operations for hypertension ventricular hemorrhage. Methods The efficacy and complications of three operation methods, including endoscope-controlled operation, Burr-hole craniotomy, ventricle puncture and drainage of urokinase infusion, were compared retrospectively. Results The complications of endoscopecontrolled operation was significantly lower than the other two methods （ X^2= 9. 966, P 〈 O. 05 ）. Among the 32 patients treated by endoscope-controUed operation,2 patients died after the surgery with a fatality rate of 6. 25 % ~ Six months after the surgery, the ADL score estimation showed grade I 2 cases, grade Ⅱ 14 cases; grade Ⅲ 11 cases ; grade Ⅳ3 cases; grade V 2 cases. Compared to the other two groups, there was significant difference （ X^2 = 10. 499,P 〈 0. 05 ）. Conclusion Endoscope-controlled operation is an effective and safe method in treating patients with hypertension ventricular hemorrhage with less brain damage, better hemorrhage clearance, and less complications when compared with small bone window craniotomy and ventricle puncture and drainage of urokinase infusion operation methods.

关 键 词：神经内窥镜控制手术 脑室出血 并发症 临床研究 

分 类 号：R651.1[医药卫生—外科学]