早期经侧脑室三角区锁孔入路治疗脑室内出血的临床研究

Clinical study of early treating cerebroventricular haemorrhage with microsurgery via key hole in triangular area of lateral cerebral ventricle

目的探讨脑室内出血早期经侧脑室三角区锁孔入路显微外科手术治疗,分析其治疗效果及对常见并发症的预防作用。方法采用经侧脑室三角区锁孔入路治疗脑室出血(A组),清除血肿,必要时行侧脑室-第三脑室造漏以治疗梗阻性脑积水及病因学治疗;并与侧脑室引流治疗脑室出血(B组)的疗效及并发症的预防作用相比较。结果A组患者脑室内血肿完全清除时间明显短于B组,病情恢复程度及并发症的发生率均明显低于B组,两种治疗方案经比较差异有显著性意义(P<0.05)。结论经侧脑室三角区锁孔入路显微手术治疗脑室出血较侧脑室引流治疗方案相比较有利于患者病情的恢复,可以有效的预防并发症并在一定程度上可以行病因学治疗。

Objective To investigate the therapeutic efficacy of early microsurgery on cerebroventricular haemorrhage resulted from various reasons through key hole approach in the triangular area of lateral cerebral ventricle, and to explore the prevention of common complications. Methods Microsurgery through key hole approach in triangular area of lateral cerebral ventricle was applied to remove the hematoma in cerebroventricular system （Group A）, and the ventage between lateral cerebral ventricle and the third cerebral ventricle was made in case of necessity to treat obstructive hydrocephalus, the common complication of cerebroventricular haemorrhage. Group B was treated with ventricular drainage. The comparison was conducted between the 2 groups in regard to the curative outcomes and complication prevention. Results Compared with Group B, Group A had a shorter duration for hematoma removal, a better recovery and a lower incidence of complications. It is significantly different between the 2 therapies （P〈0.05）. Conclusion The microsurgery through key hole approach in the triangular area of lateral cerebral ventricle is beneficial to the recovery of patients＇ condition and effective to prevent complications and apply etiological treatment to some extent.