自制鹭嘴式神经内镜鞘辅助神经内镜手术治疗高血压性脑室出血  

Endoscopic surgery assisted by self-made egret's besky neuroendoscopic sheath for hypertensive intraventricular hemorrhage

作　　者：吴春富[1] 梁建广[1] 马思原 陆华 何新俊[1] 杜延平[1] 金东[1] WU Chun-fu;LIANG Jian-guang;MA Si-yuan;LU Hua;HE Jun-fa;DU Yan-ping;JIN Dong(Department of Neurosurgery,Wuxi Chinese Medical Hospital,Wuxi 214001,China;Department of Neurosurgery,The Affiliated Hospital of Jiangnan University,Wuxi 214041,China)

机构地区：[1]南京中医药大学无锡附属医院神经外科,江苏无锡214001 [2]江南大学附属医院神经外科,江苏无锡214041

出　　处：《中国临床神经外科杂志》2020年第7期427-429,共3页Chinese Journal of Clinical Neurosurgery

基　　金：无锡市科技发展医疗卫生指导性项目(2014CSZON1416)。

摘　　要：目的探讨自制鹭嘴式神经内镜鞘辅助神经内镜手术治疗高血压性脑室出血的疗效。方法回顾性分析2013年1月至2018年1月收治的63例高血压性脑室出血的临床资料。在鹭嘴式神经内镜鞘辅助下神经内镜手术治疗21例(内镜组),单纯脑室外引流术治疗42例(引流组)。结果内镜组术后血肿清除<60%有1例,60%~90%有9例,>90%有11例;引流组术后血肿清除<60%有40例,60%~90%有1例,>90%有1例;内镜组血肿清除率明显优于引流组(P<0.01)。内镜组术后并发症发生率(4.76%,1/21)明显低于引流组(30.96%,13/42;P<0.05)。术后6个月,内镜组预后良好率(85.71%,18/21;ADL分级Ⅰ~Ⅲ级)明显高于引流组(52.38%,22/2;P<0.05)。结论对于高血压性脑室出血,自制鹭嘴式神经内镜鞘能扩大操作空间,可提高神经内镜手术血肿清除率,减少并发症,明显改善病人预后。Objective To explore the clinical effect of endoscopic surgery assisted by self-made egret's besky neuroendoscopic sheath on hypertensive ventricular hemorrhage(HVH).Methods The clinical data of 63 patients with HVH who were admitted to our hospital from January 2013 to January 2018 were retrospectively analyzed.Of these 63 patients,21 patients were treated with endoscopic surgery assisted by self-made egret's besky neuroendoscopic sheath(endoscopy group),and 42 were treated with extraventricular drainage(drainage group).Results The postoperative hematoma clearance rates<60%,60%~90%,and>90%were achieved in 1,9,and 11 patients in the endoscopy group,and in 40,1 and 1 patients in the drainage group,respectively.The hematoma clearance rate in the endoscopic group was significantly better than that in the drainage group(P<0.01).The incidence of postoperative complications in the endoscopic group(4.76%,1/21)was significantly lower than that in the drainage group(30.96%,13/42;P<0.05).Six months after surgery,the good rate of prognosis in the endoscopic group(85.71%,18/21;ADL gradesⅠ~Ⅲ)was significantly higher than that in the drainage group(52.38%,22/42;P<0.05).Conclusions For HVH,self-made egret's besky neuroendoscopic sheath can expand the operation space in order to improve the clearance rate of hematoma during neuroendoscopic surgery,reduce the complications and significantly improve the prognosis of patients.

关 键 词：高血压性脑室出血 神经内镜手术 鹭嘴式神经内镜鞘 脑室外引流术 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]