神经内镜下透明鞘内操作治疗高血压脑出血的临床应用  

Clinical application of transparent intrathecal manipulation under neuroendoscope in the treatment of hypertensive intracerebral hemorrhage

作　　者：吕新文[1] 张鹏[1] 宋建荣[1] 周小龙[1] 朱峰[1] 蔡珂[1] 张超[1] 何蓓[1] 梁媛[1] Lv Xinwen;Zhang Peng;Song Jianrong(Department of Neurosurgery,Baoji Central Hospital,Baoji,721008,China)

机构地区：[1]陕西省宝鸡市中心医院神经外科

出　　处：《立体定向和功能性神经外科杂志》2019年第1期5-8,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的比较神经内镜下透明鞘内操作清除脑内血肿,与开颅手术清除脑内血肿的优缺点。方法从2015年11月至2018年11月手术治疗脑内血肿的患者84例,采用神经内镜辅助,透明鞘内操作治疗的患者41例,开颅手术的患者43例,比较两组的手术时间,术中出血量、血肿清除率、术后第4天的颅内压、术后并发症及预后。结果两组患者在手术时间,术中出血量,血肿的清除率,术后第4天颅内压,术后并发症(例)及预后(格拉斯哥评分)良好者比较,P<0.05,差异均有统计学意义。结论神经内镜下透明鞘内操作治疗脑内血肿具有手术时间短、清除血肿较彻底、术后脑水肿反应轻、并发症少及预后较好的特点,是一种较好的清除脑内血肿的术式。Objective To compare the advantages and disadvantages of clearing intracerebral hematoma by endoscopic intrathecal hyaline operation with that by craniotomy.Methods From November 2015 to November 2018,84 patients with intracerebral hematoma were treated by neurosurgery in our hospital.Among them,41 patients were treated by endoscope-assisted,transparent intrathecal operation and 43 patients were treated by craniotomy.The operation time,intraoperative hemorrhage volume,hematoma clearance rate,intracranial pressure on the fourth day after operation,complications and prognosis were compared between the two groups.Results There were significant differences in operation time,intraoperative bleeding volume,clearance rate of hematoma,intracranial pressure on the fourth day after operation,complications(cases)and prognosis(Glasgow score)between the two groups(P<0.05).Conclusion Endoscopic hyaline intrathecal operation for intracerebral hematoma has the characteristics of short operation time,complete removal of hematoma,mild reaction to brain edema,fewer complications and better prognosis.It is a better method for removal of intracerebral hematoma.

关 键 词：脑出血 神经内镜 开颅手术 并发症 脑水肿 

分 类 号：R743.34[医药卫生—神经病学与精神病学]