微创钻孔引流术与开颅手术治疗脑室内出血的对比研究

A comparative study of minimally invasive drainage and craniotomy on intraventricular hemorrhage

目的探讨脑室内出血应用微创脑室外引流及开颅脑室内血肿清除两种治疗方法的疗效差异。方法应用历史对照(historical control trials,HCT)的统计学方法,分析2008年后应用微创钻孔治疗脑室内出血的21例病例与2008年前应用开颅血肿清除脑室血肿清除术的21例在病程、手术后并发症、预后方面的差异。结果微创钻孔治疗脑室内出血比开颅手术后的病死率低,微创组患者预后更佳且治疗时间短,方法简单易行。结论微创组与开颅组比较虽梗阻性脑积水的发生率无差异,但是微创组预后(ADL)更佳,病程更短,且微创治疗的方法简单,手术及时甚至在急诊就可以完成,是一项值得推广的技术。

Objective To investigate the difference of therapeutic effect between craniotomy hematoma evacuation and minimally invasive drainage. Methods Analyzed the effects of pathogenesis,postoperative complications,and prognosis of patients performed by minimally invasive drainage （after 2008） and craniotomy hematoma evacuation （before 2008）. Results Minimally invasive surgery had several advantages over craniotomy hematoma evacuation,lower fatality rate,less operative time,less hospitalization cost. Conclusion Though the incidence of obstructive hydrocephalus has no dif-ference between minimally invasive drainage group and craniotomy group,the minimally invasive drainage group has better prognosis comparing with craniotomy group,and minimally invasive drainage provides a sefe and effective method for ventricle hematoma and shoud be widely used.