经眉弓锁孔入路完全神经内镜下手术治疗外伤性额叶血肿的疗效  

Efficacy of fully endoscopic surgery through trans-eyebrow keyhole approach for patients with traumatic frontal hematoma

作　　者：王璨[1] 周龙 蔡强[2] 陈谦学[2] 喻军华[1] WANG Can;ZHOU Long;CAI Qiang;CHEN Qian-xue;YU Jun-hua(Department of Neurosurgery,Ezhou Central Hospital,Ezhou 436000,China;Department of Neurosurgery,East Hospital,People's Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]鄂州市中心医院神经外科,湖北436000 [2]武汉大学人民医院神经外科,武汉430060

出　　处：《中国临床神经外科杂志》2024年第3期148-150,180,共4页Chinese Journal of Clinical Neurosurgery

基　　金：鄂州市科技计划项目(基础研究与人才创新专项)(EZ01-007-20230076)。

摘　　要：目的探讨经眉弓锁孔入路完全神经内镜下手术治疗外伤性额叶血肿的疗效。方法回顾性分析2022年1月至2022年12月经眉弓锁孔入路完全神经内镜下手术治疗的7例外伤性额叶血肿的临床资料。结果入院时GCS评分6~13分,平均(10.4±2.7)分;出血量30~40 ml,平均(37.9±3.9)ml。骨窗大小约2 cm×3 cm;手术时间62~80 min,平均(70.3±6.1)min。出院时,6例GCS评分15分,1例13分。出院后随访1年,1例术后9个月出现癫痫发作,口服丙戊酸钠缓释片控制良好,其余6例正常生活。结论经眉弓锁孔入路完全内镜下手术治疗外伤性额叶血肿具有微创、高效、操作方便等优点,但需严格把握适应证,对脑疝病人不适用。Objective To investigate the efficacy of fully endoscopic surgery through trans-eyebrow keyhole approach for patients with traumatic frontal hematoma.Methods The clinical data of 7 patients with traumatic frontal hematoma treated by fully endoscopic surgery through trans-eyebrow keyhole approach from January 2022 to December 2022 were retrospectively analyzed.Results The GCS score of 7 patients ranged from 6 to 13 points at admission,with an average of(10.4±2.7)points;the volume of hemotoma was 30~40 ml,with an average of(37.9±3.9)ml.The bone window size was about 2 cm×3 cm;the surgical time was 62~80 min,with an average of(70.3±6.1)min.At discharge,6 patients had a GCS score of 15,and 1 had a score of 13.After outpatient follow-up for 1 year,1 patient had a seizure 9 months after surgery,which was well controlled by oral levetiracetam.The other 6 patients had normal lives.Conclusions Fully endoscopic surgery through trans-eyebrow keyhole approach for patients with traumatic frontal hematoma has the advantages of minimally invasive,efficient,and convenient operation,but strict indications should be followed,and it is not suitable for patients with brain herniation.

关 键 词：颅脑损伤 额叶血肿 神经内镜手术 经眉弓锁孔入路 疗效 

分 类 号：R651.15[医药卫生—外科学] R651.11[医药卫生—临床医学]