高血压丘脑出血的神经内镜微创手术治疗

Neuroendoscope-assisted micro-invasive surgical treatment of hypertensive thalamic hemorrhage

目的 探索神经内镜微创手术治疗高血压丘脑出血的效果.方法 通过改进现有神经内镜手术技术与设备,南方医科大学珠江医院等4家医院神经外科自2007年7月至2010年6月通过常规骨孔在神经内镜下微创手术治疗高血压丘脑出血患者15例,分析患者的临床资料和手术疗效.结果 本组患者平均手术时间（1.5±0.4）h,手术失血量约30～40mL,丘脑脑内血肿平均清除率为（86.2±7.9）%.随访3个月显示恢复良好3例（21.4%）,轻度残疾4例（28.6%）,重度残疾4例（28.6%）,植物状态2例（14.3%）,死亡1例（7.1%）.结论 神经内镜微创手术治疗高血压丘脑出血具有微创、高效、快速、出血少等特点.

Objective To develop a minimally invasive operating technique for the treatment of hypertensive thalamic hemorrhage. Methods The clinical data of 15 patients with hypertensive thalamic hemorrhage performed neuroendoscope-assisted micro-invasive surgical treatment in our hospitals from July 2007 to June 2010 were retrospectively analyzed; their treatment efficacy were also concluded. Results The mean operation time of these patients was （1.5±0.4） h and the amount of blood loss was 30-40 mL; the mean clearance rate of hematoma in the thalamus was （86.2 ±7.9）percentage. Patients were followed up and evaluated by Glasgow outcome scale for at least 3 months.Three patients （21.4%） showed good recovery, 4 （28.6%） moderate disability, 4（28.6%） severe disability and 2 （14.3%） vegetative survival; 1 patient （7.1%） died. Conclusion Neuroendoscope-assisted micro-invasive surgical treatment is a fast and minimally invasive operating technique with little blood loss in the treatment of hypertensive thalamic hemorrhage.