立体定向辅助神经内镜治疗基底节区高血压脑出血

Stereotactic endoscopic evacuation of spontaneous hypertensive hemorrhage of the basal ganglia

目的探讨立体定向辅助神经内镜治疗基底节区高血压脑出血破入脑室的临床疗效及适应证。方法回顾性分析粤北人民医院神经外科自2012年10月至2013年10月采用立体定向辅助神经内镜治疗的12例基底节区高血压脑出血破入脑室患者的临床资料和疗效。结果本组患者平均手术时间仅（1．6±0．51h。4例血肿清除率为70％-90％，8例血肿清除率在90％以上，均无术后再出血发生。术后6个月随访时GOS评分为恢复良好3例，轻度残疾4例，中度残疾4例，死亡1例。结论立体定向辅助神经内镜治疗基底节区高血压脑出血破入脑室具有精确、微创、手术时间短、可直视下止血、血肿清除率高等优点。

Objective To investigate the clinical efficacy and indications of stereotactic endoscopic evacuation in spontaneous hypertensive hemorrhage of the basal ganglia. Methods Twelve patients with spontaneous hypertensive hemorrhage of the basal ganglia, admitted to our hospital from October 2012 to October 2013, were treated by stereotactic endoscopic hematoma evacuation. Their clinical data were collected and retrospectively analyzed. Results Mean operative time was （1.6＋0.5） h. Postoperative CT showed that 4 received evacuation of 70%-90% of hematomas, and 8 did 90%. No intracerebral hemorrhage recurred in the patients. The follow up for 6 months after the operation was performed in 12 patients; according to Glasgow outcome scale scores, the excellent curative effects were achieved in 3 patients, good ones in 4, fare ones in 4 and death in one. Conclusion Stereotactic endoscopic hematoma evacuation enjoys characteristics as precision, minimal invasion, short operation time and high hematoma evacuation.