神经内镜技术治疗非急性期创伤性颅内血肿的疗效和安全性研究  

Neuroendoscopic treatment for non-acute traumatic intracranial hematoma:an efficacy and safety analysis

作　　者：李海春 李艳新 郭海星 迁荣军[1] Li Haichun;Li Yanxin;Guo Haixing;Qian Rongjun(Department of Neurosurgery,Henan Provincial People's Hospital,People's Hospital of Henan University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院,河南大学人民医院神经外科,郑州450003

出　　处：《中华神经医学杂志》2020年第9期937-940,共4页Chinese Journal of Neuromedicine

基　　金：河南省重点研发与推广专项项目(202102310131)。

摘　　要：目的探讨神经内镜技术治疗非急性期创伤性颅内血肿的疗效和安全性。方法回顾性收集河南省人民医院神经外科自2018年6月至2019年12月采用直切口、小骨窗开颅,神经内镜辅助下颅内血肿清除术治疗的36例非急性期创伤性颅内血肿患者的临床资料,术前1 d、术后3 d采用疼痛数字评分法(NRS)评估22例头痛患者治疗前后的疼痛程度,术前1 d、术后7 d采用日常生活能力量表(ADL)评价患者治疗前后的神经功能情况。结果36例患者均治愈出院(无死亡患者),住院时间(6.7±1.1)d。无继发性出血再次开颅患者,术后无脑脊液漏等并发症发生,无再注入尿激酶融化血肿患者。与术前[(7.82±1.097)分]比较,22例头疼患者术后NSR评分[(1.05±0.653)分]明显降低,差异有统计学意义(P<0.05)。36例患者中术前ADL分级Ⅰ级8例,Ⅱ级14例,Ⅲ级12例,Ⅳ级2例,术后30例患者神经功能完全恢复,ADL分级Ⅰ级;6例患者有轻度头晕症状,ADL分级Ⅱ级。结论采用神经内镜技术治疗非急性期创伤性颅内血肿疗效较好手术创伤少,住院时间短,安全性高。Objective To investigate the efficacy and safety of neuroendoscopy in the treatment of non-acute traumatic intracranial hematoma.Methods Thirty-six patients with non-acute traumatic intracranial hematoma,admitted to our hospital from June 2018 to December 2019,were chosen in our study.These patients accepted small-bone window craniotomy and straight incision,or removal of intracranial hematoma by neuroendoscopy.The clinical data of these patients were retrospectively analyzed.Pain numerical rating scale(NRS)was used to assess degrees of pain in 22 patients with headache one d before surgery and three d after surgery.The neurological functions after treatment were evaluated by activity of daily living(ADL)evaluation criteria one d before surgery and 7 d after surgery.Results All 36 patients were cured and discharged from hospital,and no death was noted;length of hospital stays was(6.7±1.1)d.No secondary hemorrhage re-craniotomy was needed,no postoperative complications such as cerebrospinal fluid leakage were noted,and no re-injection of urokinase was needed to melt the hematoma.As compared with the preoperative NSR scores(7.82±1.097),the postoperative NSR scores of 22 headache patients were significantly decreased(1.05±0.653,P<0.05).In these 36 patients,preoperative ADL level I was noted in 8 patients,level II in 14 patients,level III in 12 patients,and level IV in 2 patients.Postoperative nerve function in 30 patients were fully recovered,with ADL level I;and 6 patients had mild symptom of dizziness,with ADL level II.Conclusion Non-acute traumatic intracranial hematoma treated by neuroendoscopy enjoys good curative effect,less surgical trauma,short hospital stays and high safety.

关 键 词：神经内镜 非急性期 创伤性颅内血肿 微创手术 

分 类 号：R651.1[医药卫生—外科学]