神经导航联合神经内镜治疗高血压脑出血50例临床分析  

Neuronavigation-assisted neuroendoscopy for hypertensive cerebral hemorrhage:areport of 50 cases

作　　者：李乾锋[1] 杨国平[1] 罗明[1] 陈晓斌[1] 段发亮[1] 吴京雷[1] 

机构地区：[1]武汉市第一医院神经外科,430022

出　　处：《临床外科杂志》2016年第4期284-286,共3页Journal of Clinical Surgery

摘　　要：目的观察神经导航联合神经内镜治疗高血压脑出血的临床疗效。方法 132例高血压脑出血患者,应用神经导航联合神经内镜治疗高血压脑出血50例(神经内镜组)与常规开颅血肿清除术治疗高血压脑出血82例(常规手术组)临床资料进行回顾性分析,比较两组的手术时间、术中失血量、血肿清除率及术后6个月日常生活能力(ADL)。结果神经内镜组平均手术时间[(2.1±1.2)小时],明显短于常规手术组[(4.1±2.1)小时](P<0.01)。平均失血量神经内镜组为(52.5±11.3)ml,常规手术组为(458.2±185.2)ml,两组比较差异有统计学意义(t=6.125,P<0.01)。神经内镜组颅内血肿平均清除率[(94.8±5.2)%]明显高于常规手术组[(81.2±18.8)%](P<0.05)。依据ADL分级法,神经内镜组预后优于常规手术组(P<0.05)。结论神经导航联合神经内镜治疗高血压脑出血手术切口小,骨窗小,手术时间短,术中失血量少等优势。Objective To explore neuronavigation-assisted neuroendoscopy for hypertensive cerebral hemorrhage. Methods Two methods of surgery were retrospectively analyzed：the endoscopy group （ 50 cases） and craniotomy group （ 82 cases）. Surgical operation time, intraoperative blood loss, hematoma clearance rate and postoperative ability of daily life （ADL） in 6 months were observed. Results The average operation time [ （2.1 ± 1.2） h vs （4.1 ± 2.1 ） h, P 〈 0.01 ] of the endoscopy group was significantly shorter than that of craniotomy group. Blood loss [ （ 52.5 ± 11.3 ） mlvs （458.2 ± 185 ） ml, P 〈 0.01 ] in the endoscopy group, was much less than that of craniotomy group. Rates of hematoma evacuation [ （94.8 ± 5.2） % vs（81.2 ± 18.8） % ,P 〈 0.05 ] in endoscopy groupwere higher compared with craniotomy group. On the basis of ADL grading method, the prognosis of Neuronavigation-assisted neuroendoscopy was better than that of the eraniotomy （P 〈 0.05 ）. Conclusion For hypertensive cerebral hemorrhage, neuronavigation-assisted neuroendoseopyhas the advantages of minimal trauma, short operation time, and limited blood loss.

关 键 词：神经内镜 神经导航 高血压脑出血 微创神经外科 开颅血肿清除 

分 类 号：R651.12[医药卫生—外科学] R544.1[医药卫生—临床医学]