神经内镜治疗自发性脑室出血的疗效分析

Effect of neuroendoscopic treatment on spontaneous intraventricular hemorrhage

目的探讨神经内镜对自发性脑室出血手术治疗的疗效分析。方法收集2009年6月至2013年12月我院经CTA筛查的119例自发性脑室出血患者,分为2组：神经内镜手术组（NEG）48例、脑室外引流组（EVDG）71例,手术治疗均在48小时内进行;比较二组不同术式术后6小时颅脑cT,血肿清除率、术后并发症及术后6个月对患者进行ADIL预后分级等治疗效果评估。结果①血肿清除率：NEG明显优于EVDG（p〈0.01）。②术后片发症：发生率分别为1 2.5%、40.6%。NEG明显低于EVDG（p=0.048）。③术后6月ADI分级：NEG和EVDG术后6个月ADL预后评分恢复良好（ADL.Ⅰ~Ⅲ级）比例分别为：79.17%（38/48）、46.48%（33/71）。NEG术后6月ADL评分明显优于EVDG（p=0.001）。结论神经内镜组手术血肿清除率高、并发症少、预后好,优于脑室外引流手术组。

Objective To investigate the effect of neuroendoscopic treatment on spontaneous intraventricular hemorrhage. Methods A total of 119 cases of spontaneous intraventricular hemorrhage, who were admitted to our hospital between June 2009 and December 2013 with no positive findings by computed tomography angiography, were recruited in this study. The patients were divided into two groups： neuroendoscopic operation （NEG） group （48 cases） and external ventricular drainage （EVDG） group （71 cases）. All operations were performed within 48 h. A comparative study was performed between the two groups in terms of hematoma clearance rate within 6 h after operation under CT scan, incidence of postoperative complications, and ADL score 6 months after operation. Results ①The hematoma clearance rate in the NEG group was significantly higher than that in the EVDG group （ P 〈 0.01 ）. ②The incidence of postoperative complications in the NEG group （ 12.5% ） was significantly lower than that in the EVDG group （40.6%） （ P = 0. 048 ）. ③ The good recovery rates （ ADL grades Ⅰ to Ⅲ in NEG group and EVDG group 6 months after operation were 79.17% （ 38/48 ） and 46. 48% （33/71）, respectively; the good recovery rate in the NEG group was significantly higher than that in the EVDG group （P = 0. 001 ）. Conclusions Neuroendoscopic operation is superior to external ventricular drainage in treatment of intraventricular hemorrhage with higher hematoma clearance rate, fewer complications, and better prognosis.