内镜下和显微镜下手术治疗脑室出血铸型的对比分析

Minimally invasive surgery for ventricular hemorrhage cast: neuroendoscope assisted surgery vs microsurgery

目的对比分析内镜下和显微镜下手术治疗脑室出血铸型的有效性及安全性。方法 2015年6月~2016年10月前瞻性收集脑室出血铸型40例,按照随机数字表法分为内镜组(n=20)和显微镜组(n=20)。内镜组在内镜下手术清除脑室血肿,显微镜组在显微镜下手术清除脑室血肿。比较两组术后24 h血肿清除率、引流管带管时间、术后并发症发生率、出院GCS时评分、术后6个月Barthel评分。结果内镜组术后24 h血肿清除率、出院时GCS评分、术后6个月Barthel评分均明显高于显微镜组(P<0.05),而引流管带管时间明显少于显微镜组(P<0.05);两组术后并发症发生率无明显差异(P>0.05)。结论与显微镜下手术相比,内镜下手术清除脑室内血肿疗效更好。

O bjective To evaluate the effectiveness and safety of treatm ent of ventricular hemorrhage cast with neuroendosc.ope assisted surger^^and microsurgery^.M ethods Forty patients with intraventricular hemorrhage cast treated in our departm ent from June,2015 to October,2016 were randomly divided into neuroendoscope-assisted surgery group(n=20)and microsurgery^group(n=20).The rate of evacuation of hematomas 24 hours after the surgery,draining duration,rate of occurrence of postoperative complications(bleeding,intracranial infection and shunt dependent hydrocephalus),GCS score on discharge,Barthel score 6 months after the treatment were compared between both the groups.R esults The rate of evacuation of hematomas 24 hours after the surgery,GCS scores on discharge and Barthel scores 6 months after the treatm ent were significantly higher in the neuroendoscope-assisted surgery group than those in the microsurgery group(P<0.05).The drainage duration was significantly shorter in the in the neuroendoscope assisted surgery group than that in the microsurgery group(P<0.05).There was insignificant difference in the rates of occurrence of postoperative complications between the two groups(P>0.05).C onclusions The neuroendoscopie-assited surgery by which the intraventricular hematomas cast is evacuated has the advantages including minimal invasiveness,high efficiency and little impact on brain function and so on.It was worthy of clinical application and popularization.