脑窥镜直视下血肿碎吸术治疗脑出血

The treatment of intracerebral hemorrhage with smash-aspiration under direct cerebral endoscope vision

目的：观察脑窥镜治疗脑出血的效果。方法：采用国产硬质脑窥镜治疗脑出血16例，应用加拿大人神经病学评分判断神经功能缺损，评价治疗效果。结果：16例病人中，血肿清除量在80％以上者9例，其中完全清除4例；60～80％清除者3例；清除量小于60％者2例；2例未复查CT。发病后12小时内治疗者4例，3例死亡，1例转脑外科手术，均为再出血，其加拿大人神经病学评分（CNS）由治疗前的6．85±0．21减少为治疗后的3．46±0．41（P＜0．001），发病后24～72小时内治疗者9例，72小时以上治疗者3例，均全部存活，其CNS由治疗前的6．94±0．37增加到8．99±0．26（P＜0．001）。结论：脑窥镜直视下清除血肿方法简便、直观，血肿清除率高，术后病人意识障碍恢复快，但早期手术易引起再出血而增加死亡率。

Objectives to observe the treatment effect of cerebral endoscope (CES) on intracerebral hemorrhage (IH). Methods 16 cases of IH were treated with domestic metal CES and the canadian neurlogi-cal scale (CNS) was applied to judge the effect. Reults of 16 cases,9 cases were evacuated more than 80%, among them 4 cases were com-pletely evacuated, and 3 cases 60%～80%, 2 cases less than 60%, 2 cases no CT.Treated in 12 hours of stroke were 4 cases, 3 died and 1 transferred to surgical treated, owing to rehemorrhage, their CNS were decreased significantly from 6.85±0.21 before treatment to 3.46±0.41(P<0.001); while the others,9 cases treated in 24～72 hours of stroke, 3 cases more than 72 hours, were alive, and their CNS were highly increased from 6.94±0.37 before treatment to 8.99±0.26(P<0.001). Conclusion Haematoma smash-aspiration under direct CES vision is a simple and effective tool in treating IH, and the conscious-ness of the patient is recomvered rapidly after treatment. but if treated in iess than 12 hours of stroke, the patient may be in jeopardy of his life.