微骨瓣额中回入路治疗重型脑室出血  

The Treatment of Severe Intraventricular Hematoma through Midfrontal Keyhole Approach

作　　者：崔永华[1] 夏咏本[1] 张立勇[1] 韩清[1] 陈恒林[1] 

机构地区：[1]南通大学附属建湖医院神经外科224700

出　　处：《天津医药》2014年第2期179-181,共3页Tianjin Medical Journal

摘　　要：目的探讨微骨瓣额中回入路在重型脑室出血中的应用价值。方法回顾性分析21例微骨瓣额中回入路治疗重型脑室出血的临床资料。结果术后脑室内外血肿清除满意,改善了GCS评分、脑室积血Graeb评分。主要并发症:弥漫性脑肿胀1例,脑血管痉挛3例,颅内感染1例,肺部感染7例。随访1～6个月,按ADL分级恢复良好5例,中度残疾9例,重度残疾3例,植物生存1例,死亡3例。结论微骨瓣经额中回入路可有效清除脑室内外血肿,及时解除梗阻性脑积水,减轻继发性脑损害,改善患者的预后。Objective To evaluate the clinical value of midfrontal keyhole approach for the treatment of severe intra- ventricular hematoma. Methods The clinical data of 21 cases of severe intraventricular hemorrhage through midfrontal key- hole approach were analyzed retrospectively. Results Both inside and outside intraventricular hematoma were satisfied cleared. The GCS score and intraventricular hemorrhage Graeb score were improved. There were complications after opera- tion including 1 patient with diffuse brain swelling, 3 patients with cerebral vasospasm, 1 patient with intracranial infection, and seven patients with pulmonary infection. Follow-up schedules included 1-6 months. According to ADL score, 5 patients recovered well, 9 patients were moderately disabled, 3 were severely disabled, 1 was in a vegetative state and 3 died. Conclu- sion The intraventricular hematoma can be removed through midfrontal keyhole approach. The obstructive hydrocephalus can be relieved, the secondary brain damage was reduced and the prognosis was improved in patients.

关 键 词：脑出血 脑室 显微外科手术 额 血肿 引流术 

分 类 号：R651[医药卫生—外科学]