急诊科开展神经内窥镜手术的初步报告

Preliminary report on application of neuroendoscope in the emergency department

目的 :探讨神经内窥镜在急诊科的应用价值。方法 :1999年 7月至 2 0 0 0年 3月我院急诊科开展神经内窥镜手术治疗各类颅内血肿 2 3例 2 4次 ,其中脑内血肿清除术 2 0例 ,慢性硬膜下血肿 /积液引流术 3例。结果 :根据ADL评分标准 ,脑血肿组治疗效果为基本痊愈(ADL1级 ) 2例 ,显著进步 (ADL改善≥ 2级 ) 6例 ,进步 (ADL改善 1级 ) 6例 ,无改变 1例 ,死亡 5例 ;超早期治疗的 3例效果最好。 3例硬膜下血肿 /积液均治愈。本组并发术后出血 2例 ,切口脑脊液漏 1例 ,无其它手术直接相关的并发症。结论 :神经内窥镜手术创伤小 ,直视下操作 ,并发症少 ,病人康复快 ,为脑出血、慢性分隔型硬膜下血肿的治疗提供了一种新的有效方法 ,值得在急诊科开展。

Objective:To evaluate the application of neuroendoscope in the emergency department.Methods:From July 1999 to March 2000,23 patients were operated using the neuroendoscope in our department.Intracerebral hematoma were evacuated in 20 patients and chronic subdural hematoma in 3.Results:In patients with intracerebral hematoma,2 cases were cured,6 with significant improvement、6 with improvement and 1 with no change according to ADL scores;5 patients died.Other patients were cured.There were no direct complications of operation except two patients had postoperation hemorrhage and one had CSF leak.Conclusion:Operation using neuroendoscope is minimally invasive,with few complications and rapid recovery.It offers a new treatment modality for intracerebral hematoma and chronic subdural hematoma.So its application in the emergency department is warranted.