神经内镜脑室血肿消除术治疗脑室出血伴铸型的疗效观察  

Clinical study of neuroendoscopic surgery for ventricular hemorrhage

作　　者：王学蛟[1] Wang Xuejiao(Department of Neurosurgery, No.3 People's Hospital of Datong,Datong Shanxi 037008,China)

机构地区：[1]大同市第三人民医院神经外科,山西大同037008

出　　处：《医药前沿》2019年第27期39-41,共3页Journal of Frontiers of Medicine

摘　　要：目的:分析神经内镜手术治疗脑室出血(IVH)的效果.方法:选择2015年10月-2018年4月于大同市第三人民医院神经外科接受治疗的47例脑室出血伴铸型患者,随机分为对照组(n=24)、观察组(n=23).对照组给予脑室穿刺外引流术治疗,观察组行神经内镜脑室血肿清除术.比较两组患者的手术时间、住院时间以及术后引流管留置时间、血肿有效清除率、脑积水以及颅内感染的发生率.结果:1.观察组住院时间(t=11.581,P=0.000)以及术后引流管留置时间(t=5.607,P=0.000)均短于对照组,差异有统计学意义(P<0.05).观察组手术时间长于对照组(t=9.883,P=0.000),差异有统计学意义.2.观察组血肿有效清除率高于对照组,差异有统计学意义(χ^2=5.093,P=0.024);观察组颅内感染发生率(χ^2=5.436,P=0.020)以及脑积水发生率(χ^2=4.809,P=0.028)均低于对照组,差异均有统计学意义(P<0.05).结论:临床中选择神经内镜手术治疗脑室出血,可以有效缩短住院时间,减少引流管留置时间,提高血肿清除率,还能有效降低脑积水及颅内感染的发生率,效果优于脑室穿刺外引流术,具有相对安全性,是一种有效、可靠、值得应用的手术方式.Objective To study the effect of neuroendoscopic surgery on intraventricular hemorrhage(IVH).Methods Forty-seven patients with ventricular hemorrhage and cast type who were treated in the Department of Neurosurgery,Datong No.3 People's Hospital from October 2015 to April 2018 were enrolled in the control group(n=24)and the observation group(n=23).).The control group was treated with ventricle puncture drainage,and the observation groupunderwent neuroendoscopic ventricular hematoma evacuation.The operation time,hospitalization time, postoperative drainage tube indwelling time,effective hematoma clearance rate,hydrocephalus and intracranial infection were compared between the two groups.Results 1.The length of hospital stay in the observation group(t=-11.581,P=0.000)and postoperative drainage tube retention time(t=-5.607, P=0.000)were lower than the control group,the difference was statistically significant.The operation time of the observation group was higher than that of the control group(t=9.83,P=0.00),and the difference was statistically significant.2.The effective clearance rate of hematoma in the observation group was higher than that in the control group,the difference was statistically significant(χ^2=5.093, P=0.024);the incidence of intracranial infection in the observation group(χ^2= 5.436,P=0.020) and the incidence of hydrocephalus(χ^2=4.809, P=0.028)were lower than the control group,and the differences were statistically significant.Conclusion The choice of neuroendoscopic surgery for intraventricular hemorrhage can effectively shorten the length of hospital stay,reduce the indwelling time of drainage tube,improve the clearance rate of hematoma,and effectively reduce the incidence of hydrocephalus and intracranial infection. External drainage, with relative safety,is an effective,reliable and worthwhile surgical Procedure.

关 键 词：脑室出血 神经内镜手术 脑室穿刺外引流术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]