神经导航及内镜下小骨窗治疗高血压脑出血

Neuronavigation-assisted neuroendoscopy via keyhole in treatment of hypertensive cerebral hemorrhage

目的评价神经导航辅助内镜使用一次性透明鞘小骨窗治疗高血压基底节区脑出血的临床疗效。方法回顾性分析54例采用神经导航辅助内镜治疗高血压基底节区脑出血患者的临床资料。结果 54例患者手术切口长度为3~4 cm,骨窗直径2~2.5 cm,手术时间45~110分钟(平均70分钟),平均血肿清除率95%。术后6个月GOS评分:恢复良好10例,轻度残疾15例,重度残疾27例,植物生存0例,死亡2例。结论神经导航辅助内镜使用一次性透明鞘小骨窗入路治疗高血压脑出血疗效确切,其优点微创、精准、省时及预后好,经颞入路仍是直接简便的入路,因此该技术具有较高的临床应用价值。

Objective To evaluate the efficacy of neuronaviagation-assisted neuroendoscopy via the keyhole with disposable transparent sheaths in tbe treatment of hypertensive cerebral hemorrhage.Methods The clinical data of 54 patients with hypertensive cerebral hemorrhage who underwent neuronavigation-assisted neuroendoscopy via keyhole with disposable transparent sheaths were reviewed.Results In the 54 patients,the length of scalp incision was 3-4 cm,and the keyhole diameter was 2-2.5 cm;the mean operation time was 70 min （45-110 min）,and the mean hematoma clearance rate was 95％.The Glasgow Outcome Score at 6 months after surgery indicated 10 cases of good recovery,15 cases of mild disability,27 cases of severe disability,0 case of vegetative state,and 2 cases of death.Conclusions Neuronavigation-assisted neuroendoscopy via the temporal keyhole using disposable transparent sheaths is a minimally invasive,precise,time-saving,and effective treatment for hypertensive cerebral hemorrhage with good prognosis.Its simple and direct approach makes the technique suitable for wide clinical application.