脑室镜辅助下微创手术治疗基底节出血

Minimal invasive surgery combined with ventriculoscope for the treatment of basal ganglia hemorrhage

目的探讨脑室镜辅助下微创手术治疗基底节出血的安全性和有效性。方法回顾性分析2014年6月至2015年6月我院收治的57例基底节大出血患者的临床资料,根据术式的不同将患者分为脑室镜辅助下微创手术组和开颅手术组,比较2组患者的临床预后。结果与开颅手术组相比,脑室镜辅助下微创手术组患者术后7、14和28 d时格拉斯哥昏迷评分显著增高,差异有统计学意义(P=0.02、0.04、0.04);住院时间显著缩短[(21.45±5.67)d vs.(25.67±7.45)d,P=0.02];手术时间显著缩短[(134.45±21.11)min vs.(178.65±45.32)min,P=0.000)]。2组患者颅内压力变化、血肿清除率、器官功能衰竭率、再出血率和28 d病死率,差异均无统计学意义(P>0.05)。结论脑室镜辅助下微创手术治疗基底节出血安全、有效。

Objective To investigate the effectiveness and safety of minimal invasive surgery combined with ventriculoscope for the treatment of basal ganglia hemorrhage. Methods From June 2014 to June 2015 there were 57 patients with basal ganglia hemorrhage were selected into this study. These patients were signed into the minimal invasive surgery combined with ventrieuloscope group and the craniotomy group according to the methods of surgery they received. And the clinical outcomes of the two groups were compared. Results Compared with the craniotomy group, patients in the minimal invasive surgery combined with ventriculoscope group got a significantly lower Glasgow coma scale at 7 days, 14 days and 28 days after the operation （P = 0.02,0.04,0.04） ;the hospital stays were significantly reduced in the minimal invasive surgery combined with ventriculoscope group [ （ 21.45± 5.67 ） d vs. （ 25.67 ± 7.45 ） d, P = 0.02 ] ; and the operation time were significantly reduced as well [ （ 134.45 ± 21.11 ） rain vs. （ 178.65 ±45.32） min,P = 0. 000 ） ]. There was no significant difference in intra- cranial pressure, rate of hematoma clearance, rate of organ functional failure, rate of re-bleeding and mortality 28 days after operation （ P 〉 0.05 ）. Conclusion The minimal invasive surgery combined with ventrieuloscope is effective and safe for the treatment of basal ganglia hemorrhage, which is worthy of popularization.