神经内镜血肿清除术联合第三脑室造瘘对脑室内血肿术后脑积水发生率的影响  

Study the effect of neuroendoscopic hematoma removal combined with third ventricle fistula on the incidence of hydrocephalus after intraventricular hematoma surgery

作　　者：邱建国[1] 何睿瑜[1] 王辉[1] QIU Jian-guo;HE Rui-yu;WANG Hui(Department of Neurosurgery,Foshan First People's Hospital,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院神经外科,广东佛山528000

出　　处：《中国处方药》2020年第12期12-13,共2页Journal of China Prescription Drug

基　　金：佛山市卫生健康局医学科研课题(20190049)。

摘　　要：目的探讨神经内镜血肿清除术联合第三脑室造瘘对脑室内血肿术后脑积水发生率的影响。方法选取2019年1月~2020年5月就诊的脑室内血肿患者72例,随机分为造瘘组(36例)和血肿组(36例),两组患者均给予神经内镜血肿清除术治疗,造瘘组在此基础上联合第三脑室造瘘术,比较两组患者术后3 d脑积水发生率、术后各项临床指标和两组患者术前和术后3个月神经功能(NIHSS)和生活质量(GQOLI)评分。结果术后3 d,造瘘组脑积水发生率(8.33%)显著低于血肿组(27.78%)(χ^2=4.60,P=0.03),造瘘组术后6 h血肿清除率47.22%显著高于血肿组22.22%(P <0.05),造瘘组术后死亡、术后再出血和术后颅内感染均略低于血肿组,术前两组NIHSS、GQOLI评分比较差异无统计学意义(P>0.05),术后造瘘组NIHSS评分显著低于血肿组、GQOLI评分显著高于血肿组(P <0.05)。结论对脑室内血肿患者实施神经内镜血肿清除术联合第三脑室造瘘治疗能够有效降低患者术后脑积水发生率,提高患者血肿清除率并改善患者神经功能和生活质量。Objective To investigate the effect of neuroendoscopic hematoma removal combined with third ventricle fistula on the incidence of hydrocephalus after intraventricular hematoma surgery.Methods A total of 72 patients with intraventricular hematoma who were treated from January 2019 to May 2020 were randomly divided into fistula group(36 cases)and hematoma group(36 cases).Both groups were treated with neuroendoscopic hematoma removal.On this basis,the fistula group was combined with the third ventricle fistula,then compared the incidence of hydrocephalus 3th days after the operation,various clinical indicators after the operation,and the neurological function of the two groups before and 3th months after the operation(NIHSS)and quality of life(GQOLI)scores.Results Three days after operation,the incidence of hydrocephalus in the fistula group(8.33%)was significantly lower than that in the hematoma group(27.78%)(χ^2=4.60,P=0.03),and the hematoma clearance rate in the fistula group 6 hours after surgery was 47.22%,which was higher than that in the hematoma group 22.22%(P<0.05).The postoperative death,postoperative rebleeding and postoperative intracranial infection in the fistula group were slightly lower than those in the hematoma group.There was no statistically significant difference in NIHSS and GQOLI scores between the two groups before surgery(P>0.05),the NIHSS score of the postoperative fistula group was significantly lower than that of the hematoma group,and the GQOLI score was significantly higher than that of the hematoma group(P<0.05).Conclusion The neuroendoscopic hematoma removal combined with third ventricle fistula treatment for patients with intraventricular hematoma can effectively reduce the incidence of postoperative hydrocephalus,increase the removal rate of hematoma,and improve the neurological function and quality of life.

关 键 词：神经内镜血肿清除术 第三脑室造瘘术 脑室内血肿 脑积水 

分 类 号：R651.1[医药卫生—外科学]