神经内镜血肿清除术治疗重型脑室出血患者的临床价值  

The clinical value of drilling external drainage and neuroendoscopic hematoma removal in patients with severe ventricular hemorrhage

作　　者：黄俊红[1] 叶党华[1] 凌国锋[1] 桂志勇[1] HUANG Junhong;YE Danghua;LING Guofeng;GUI Zhiyong(Department of Neurosurgery,Luohe Central Hospital,Luohe 462000,China)

机构地区：[1]漯河市中心医院神经外科,河南漯河462000

出　　处：《包头医学院学报》2021年第2期25-28,共4页Journal of Baotou Medical College

摘　　要：目的:分析神经内镜血肿清除术在重型脑室出血患者中的应用价值。方法:选取接受治疗的重型脑室出血患者60例,依照手术方案不同分为钻孔组和内镜组,各30例。钻孔组患者采用钻孔外引流术,内镜组患者采用神经内镜血肿清除术,比较两组患者的手术时间、引流管放置时间、住院时间、术后48 h血肿清除率、并发症发生率及术前、术后3个月Barthel指数、爱丁堡-斯堪的纳维亚(MESSS)评分。结果:内镜组患者术后48 h血肿清除率高于钻孔组(P<0.05);术后3个月内镜组Barthel指数评分高于钻孔组,MESSS评分低于钻孔组(P<0.05);内镜组并发症发生率6.67%低于钻孔组的26.67%(P<0.05)。结论:神经内镜血肿清除术治疗重型脑室出血患者血肿清除率高于钻孔外引流术,可改善患者神经功能及日常生活能力,且安全性高。Objective:To analyze the application value of drilling external drainage and neuroendoscopic hematoma removal in patients with severe ventricular hemorrhage.Methods:A total of 60 patients with severe ventricular hemorrhage who received treatment were selected and divided into drilling group and endoscopy group according to different surgical plans,with 30 cases in each.Drilling group used external drainage,while endoscopy group used neuroendoscopic hematoma removal.The operation time,drainage tube placement time,hospital stay,48 h postoperative hematoma removal rate,complication rate and Barthel index 3 months before and after surgery and Edinburgh-Scandinavian(MESSS)score were compared between the two groups.Results:The clearance rate of hematoma in the endoscopy group was higher than that of the drilling group at 48 hours after surgery(P<0.05);the Barthel index score of the endoscopy group was higher than that of the drilling group at 3 months postoperatively,and the MESSS score was lower than that of the drilling group(P<0.05);the complication rate of the endoscopy group was 6.67%lower than that of the drilling group(P<0.05).Conclusion:The clearance rate of neuroendoscopic hematoma in patients with severe ventricular hemorrhage is higher than that of external drainage,which can significantly improve the patients'neurological function and ability of daily living,and has high safety.

关 键 词：重型脑室出血 钻孔外引流术 神经内镜血肿清除术 血肿清除率 神经功能缺损 并发症 

分 类 号：R65[医药卫生—外科学]