神经内镜联合脑室外引流治疗脑室出血临床效果分析  

CLINICAL ANALYSIS OF NEUROENDOSCOPY COMBINED WITH EXTRAVENTRICULAR DRAINAGE IN THE TREATMENT OF INTRAVENTRICULAR HEMORRHAGE

作　　者：董伟[1] 张于[1] 岳成 高健 石文建[1] 高华 Dong Wei;Zhang Yu;Yue Cheng(The People's Hospital of Tangshan,Tangshan 063000,tChina)

机构地区：[1]河北省唐山市人民医院神经外科,063000 [2]北京市神经外科研究所

出　　处：《中国煤炭工业医学杂志》2019年第6期606-610,共5页Chinese Journal of Coal Industry Medicine

基　　金：北京市卫生系统高层次卫生技术人才培养计划项目(编号:2015-3-040)

摘　　要：目的分析神经内镜联合脑室外引流(external ventricular drainage,EVD)治疗脑室出血与传统单纯EVD治疗脑室出血的效果。方法选取2016年1月-2019年1月符合标准的107例脑室出血患者,采用不同方法治疗的脑室出血患者分为联合治疗组(57例)以及EVD组(50例)。通过单纯EVD治疗或者经额小骨窗内镜套筒指引下血肿清除合并EVD治疗后比较二组患者术后恢复情况等相关指标。结果二组在总的治疗效果方面比较差异有统计学意义(P<0.05),联合治疗组患者在平均住院时间以及颅内感染方面与单纯EVD组比较有统计学意义(P<0.05)。在联合治疗组年龄>45岁组,手术在发病6h内,四脑室铸型不严重的患者组中效果明显,差异有统计学意义(P <0.05),而单纯EVD组差异无统计学意义(P>0.05)。结论随着神经内镜技术的成熟发展,脑室出血铸型的患者宜选用神经内镜辅助联合脑室外引流治疗。Objective To analyze the effect of neuroendoscopy combined with external ventricular drainage(EVD) in the treatment of intraventricular hemorrhage and traditional EVD alone in the treatment of intraventricular hemorrhage.Methods From January 2016 to January 2019,one hundred and seven patients with intraventricular hemorrhage who met the standard were selected.Patients with intraventricular hemorrhage treated by different methods were divided into the combined treatment group(57 cases) and EVD group(50 cases).After EVD treatment alone or under the guidance of endoscopic sleeve through the frontal small bone window,hematoma clearance and EVD treatment were compared between the two groups.Results There was significant difference in the total treatment effect between the two groups(P<0.05).The patients in the combined treatment group had significant difference in the average hospitalization time and intracranial infection compared with the EVD group(P<0.05).In the combined treatment group,the age was less than 45 years old.Within 6 h after the operation,the effect was significant in the patients group with no severe casting of four ventricles(P<0.05),but there was no significant difference in the EVD group(P>0.05).Conclusion With the development of neuroendoscopy,the patients with intraventricular hemorrhage should be treated with neuroendoscopy combined with extraventricular drainage.

关 键 词：神经内镜 EVD 脑室出血 

分 类 号：R651.1+1[医药卫生—外科学]