神经内镜治疗脑室出血铸型的疗效评价  

The therapeutic effects of endoscopic surgery on intraventricular hemorrhage

作　　者：李鹏[1] 张建辉[1] 郝亮[1] 张义 杨晓 姚志刚[1] LI Peng;ZHANG Jianhui;HAO Liang(Department of Neurosurgery,The Third Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第三医院神经外科,050011

出　　处：《河北医药》2021年第11期1686-1688,1692,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展计划(编号:161462403)。

摘　　要：目的对脑室出血的外科临床治疗实践中神经内镜的有效性与安全性进行分析探索。方法研究对象为54例脑室出血铸形的患者,单纯脑室引流组(引流组)为脑室穿刺引流,神经内镜组(内镜组)32例为神经内镜下开颅手术,观察指标有脑室系统积血量、术后并发症发生率、日常生活能力评分(ADL)。结果在内镜组,术后1、3、7 d脑室系统积血量(ml)分别为(4.73±3.01)ml、(2.46±1.53)ml、(1.69±0.75)ml,引流组分别为(9.47±2.38)ml、(6.07±1.79)ml、(4.43±1.25)ml,引流组样本病例脑室残存积血量显著大于观察组(P<0.05);内镜组术后颅内感染、肺部感染、脑积水的发生率分别为18.75%、31.25%、6.25%,分别低于引流组的36.36%、54.54%、13.63%(P<0.05);引流组样本病例ADL评分(术后180 d)良好率45.45%,显著低于内镜组的71.88%(P<0.05)。结论脑室出血采用神经内镜治疗策略时,安全、彻底、快速、有效,在熟练的手术操作和合适的适应症前提下,可以明显改善患者预后。Objective To investigate the therapeutic effects and safety of endoscopic surgery in treatment of intraventricular hemorrhage.Methods A total of 54 patients with intraventricular hemorrhage were randomly divided into control group(n=22)and observation group(n=32).The patients in control group were treated by ventricular puncture drainage,however,the patients in observation group were treated by craniotomy under neural endoscope.The ventricular hematocele volume,the incidence rate of postoperative complications,ability of daily life(ADL)score were observed and compared between the two groups.Results The ventricular hematocele volumes at1d,3d,7d after operation in observation group were(4.73±3.01)ml,(2.46±1.53)ml,(1.69±0.75)ml,respectively,which were significantly higher than those[(9.47±2.38)ml,(6.07±1.79)ml,(4.43±1.25)ml]in control group(P<0.05).The incidence rates of postoperative intracranial infection,pulmonary infection and hydrocephalus in observation group were 18.75%,31.25%,6.25%,respectively,which were significantly lower than those(36.36%,54.54%,13.63%)in control group(P<0.05).Moreover the good/excellent rate of ADL scores(at 180 days after operation)in control groupl was 45.45%,which was significantly lower than that(71.88%)in observation group(P<0.05).Conclusion The endoscopic surgery is safe,complete,quick and effective in treating intraventricular hemorrhage,which can significantly improve the prognosis of patients.

关 键 词：脑室出血 神经内镜 脑室穿刺引流 

分 类 号：R743.34[医药卫生—神经病学与精神病学]