导航联合内镜技术与小骨窗开颅术治疗脑出血的疗效比较  

Comparison of curative efficiencies between neuronavigation combined with neuroendoscopy and small skull-window craniotomy for cerebral hemorrhage

作　　者：阮航[1] 杨国平 罗明[1] 段发亮[1] 张严国[1] 闵强[1] Ruan Hang Yang Guoping Luo Ming Duan Faliang Zhang Yanguo Min Qiang(Department of Neurosurgery, Wuhan No. 1 Hospital, Wuhan 430022, China Department of Neurosurgery, Hanyang Hospital of Wuhan, Wuhan 430050, Chin)

机构地区：[1]武汉市第一医院神经外科,430022 [2]武汉市汉阳医院神经外科,430050

出　　处：《中华实验外科杂志》2016年第11期2573-2575,共3页Chinese Journal of Experimental Surgery

基　　金：武汉市医药卫生临床重点学科研究项目（武卫[2008]70）

摘　　要：目的 比较神经导航联合神经内镜技术（简称：导航内镜）和小骨窗开颅（简称：小骨窗）两种手术方式治疗高血压脑出血的临床疗效.方法 将高血压脑出血需手术治疗病例共67例,随机分成导航内镜组35例和小骨窗组32例进行治疗,对比分析两组病例的手术时间、皮层切口长度、血肿清除率及术后死残率.结果 导航内镜组手术时间为（82±25） min、皮层切口为（1.5±0.2） cm、血肿清除率为（86±13）％、死亡率为2.9％（1/35）,残疾比例为19/35,死残率为57.14％;小骨窗开颅组手术时间为（125±33） min、皮层切口为（3.5±0.5）cm、血肿清除率为（72±18）％、死亡率为3.1％ （1/32）,残疾比例为18/32,死残率为59.38％;除死亡和重残率比较差异无统计学意义（P＞0.05）外,导航内镜组的其他各项指标均优于小骨窗组（P＜0.05）.结论 采用神经导航联合神经内镜技术治疗高血压脑出血可缩短手术时间、减少手术创伤、提高血肿清除率,该手术方法定位准、微创、安全、有效.Objective To compare the curative efficiencies of neuronavigation combined with nervous endoscopy （short for navigation endoscopy） and small skull-window craniotomy （short for small window craniotomy） for hypertensive cerebral hemorrhage.Methods Sixty-seven cases of hypertensive cerebral hemorrhage were divided into two groups：35 cases given navigation endoscopy and 32 cases given small skull-window craniotomy,and operation time,cortex incision length,hematoma clearance rate and the death and disability rate after operation were compared between two groups.Results The operation time in navigation endoscopy group was （82 ± 25） min,the cortex incision was （1.5 ± 0.2） cm,the hematoma clearance rate was about （86 ± 13）%,and there was 1 death and 19 cases of disabilitywith the death and disability rate being 57.14%.The operation time in the small skull-window craniotomy group was （125 ± 33） min,the cortex incision was （3.5 ± 0.5） cm,the hematoma clearance rate was about （72 ± 18）%,and there was one death and 18 cases of disability with the death and disability rate being 59.38%.Except that there was no obvious difference in the death and disability rate,the indicators in navigation endoscopy group were superior to those in small skull-window craniotomy group （P 〈 0.05）.Conclusion Adopting neuronavigation technique combined with neuroendoscopy can shorten the operation time,reduce the surgical trauma and increase the hematoma clearance rate.Such surgical method is of correctly positioning,minimally invasive,safe and effective.

关 键 词：神经导航 神经内镜 高血压 脑出血 手术 

分 类 号：R651[医药卫生—外科学]