一次性便携式内镜在经顶上小叶清除丘脑血肿中的优势  

Advantages of disposable portable endoscope in removing thalamic hematoma via the superior parietal lobule

作　　者：颜辉[1] 吴浩[1] 杨金福[1] 姜交德[1] 杨帆[1] 杨慧[2] YAN Hui;WU Hao;YANG Jinfu;JIANG Jiaode;YANG Fan;YANG Hui(Department of Neurosurgery,Third Xiangya Hospital,Central South University,Changsha 410013;Department of Anesthesiology,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院神经外科,长沙410013 [2]中南大学湘雅三医院麻醉科,长沙410013

出　　处：《中南大学学报（医学版）》2024年第8期1261-1270,共10页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(82101317);湖南省自然科学基金(2023JJ60514)。

摘　　要：目的:丘脑血肿患者病情多变,治疗方式也呈现多样化。目前一次性便携式内镜手术在各医院的开展较为迅速,但手术效果差异较大;对于丘脑血肿的清除,多参照基底节出血的手术入路和手术方式,手术效果并不明确。本研究旨在探讨一次性便携式内镜在经顶上小叶清除丘脑血肿中的优势,为手术医师采取合理有效的手术方案处理丘脑血肿提供参考依据。方法:回顾性分析在中南大学湘雅三医院进行一次性便携式内镜手术或显微镜手术的丘脑血肿患者的临床资料。比较2组患者的手术时间、血肿清除率、住院时间、术后24 h格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分改善率和肺部感染率。结果:与显微镜组比较,一次性便携式内镜组的手术时间短、血肿清除率高、住院时间短、肺部感染率低(均P<0.05);但2组术后24 h GCS评分改善率的差异无统计学意义(P>0.05)。结论:一次性便携式内镜在经顶上小叶清除丘脑血肿手术的应用中,具有手术时间短、手术视野大、血肿清除率高、手术效率高、住院时间短、肺部感染率低等优势,可以作为丘脑血肿患者优先选择的手术治疗方案之一。Objective:Thalamic hematoma patients present with diverse clinical conditions,and treatment approaches vary widely.Currently,the use of disposable portable endoscope surgery has been rapidly adopted in many hospitals,but outcomes can vary significantly.Surgical approaches and techniques for thalamic hematoma often reference those used for basal ganglia hemorrhage,but their effectiveness remains uncertain.This study aims to explore the advantages of using disposable portable endoscopes in removing thalamic hematoma via the superior parietal lobule,providing guidelines for clinicians to manage thalamic bleeding effectively.Methods:Clinical data of patients with thalamic hematoma who underwent either disposable portable endoscope or microscope surgery at the Third Xiangya Hospital,Central South University,were retrospectively analyzed.Surgical duration,hematoma clearance rate,length of hospital stay,improvement rate in Glasgow Coma Scale(GCS)score at 24 hours post-operation,and incidence of pulmonary infection were compared between the 2 groups.Results:Compared with the microscope group,the disposable portable endoscope group had shorter operation time,higher hematoma clearance rate,shorter hospital stay,and lower incidence of pulmonary infection(all P<0.05).However,there was no significant difference in the improvement rate of GCS score at 24 hours post-operation between the 2 groups(P>0.05).Conclusion:In the surgical removal of thalamic hematoma via the superior parietal lobule,the disposable portable endoscope offers advantages such as shorter surgical duration,better visualization,higher hematoma clearance rate,improved surgical efficiency,shorter hospital stay,and lower incidence of pulmonary infection.Therefore,it can be considered as a preferred surgical treatment option for patients with thalamic hematoma.

关 键 词：顶上小叶入路 丘脑出血 基底节出血 内镜手术 显微镜手术 一次性便携式内镜 

分 类 号：R651.1[医药卫生—外科学]