脑室镜治疗脑室出血的临床疗效

Clinical application of endoscope on treatment of intraventricular hemorrhage

目的探讨应用脑室镜清除脑室内血肿治疗脑室出血的疗效。方法回顾性分析18例脑室出血患者的临床资料。结果患者入院12h内在脑室镜下清除脑室内血肿，手术结束术区置管，术后向脑室内注入尿激酶，拔管后腰穿腰大池置管持续引流脑脊液；术后24h复查头颅CT，脑室内血肿清除80％以上者占12例；术后2个月对患者进行GOS评分，5分（优）4例，4分（良）8例，3分（中）3例，2分（差）2例，1分（死亡）1例，恢复优良率为67％。结论早期应用脑室镜清除脑室内血肿可改善患者的预后、降低并发症，具有直视下操作、迅速有效地清除脑室内血肿、术后恢复快等优点。

Objective To explore the treatment effects of application of endoscopy evacuation of intraventricular hematoma. Methods The clinical data of 18 cases with intraventricular hemorrhage were analyzed retrospectively. Intraventricular endoscopy hemorrhage evacuation were performed for those patients within 12 h after the admission. Intraventricular injection of urokinase and lumbar cistern continuous drainage of cerebrospinal fluid were performed after operation. Results Postoperative CT within 24 h showed nearly complete evacuation of intraventricular hematoma in 12 cases. All patients were followed - up for two months. According to GOS, the result was excellent in 4 cases, good in 8, fare in 3, poor in 2 and dead in 1. The excellent recovery rate was 67%. Conclusions Early application of intraventricular endoscopy evacuation of intraventricular hematoma could improve the patient＇s prognosis and reduce complications of intraventricular hemorrhage. It is characterized by visualized manipulation, rapid and effective hematoma evacuation and rapid postoperative recovery.