神经内镜下治疗脑出血破入脑室的效果研究

Endoscopic surgical treatment for cerebral hemorrhage breaking into patients ventricle

目的探究脑出血破入脑室患者的内镜下外科治疗效果。方法选取2015年1月-2018年1月该院收治的66例脑出血破入脑室的患者为研究对象,将患者依据随机数字表法分为对照组(n=33)和观察组(n=33)。对照组患者行常规显微镜下脑实质血肿清除术联合脑室钻孔引流术治疗,观察组患者行神经内镜辅助下脑实质和脑室内血肿清除术联合置管引流术。比较两组患者的围术期情况、血肿清除率、预后情况和并发症情况。结果两组患者的手术时间比较,差异无统计学意义(P>0.05)。观察组患者的颅内感染率和再出血率低于对照组患者,格拉斯哥昏迷评分(GCS)高于对照组患者,差异有统计学意义(P<0.05)。两组患者术后1、3和7 d脑实质的血肿清除率比较,差异无统计学意义(P>0.05);观察组患者术后1、3和7 d脑室内的血肿清除率均高于对照组患者,差异有统计学意义(P<0.05)。观察组与对照组患者预后良好率分别为69.69%和33.33%,术后并发症总发生率分别为27.27%和45.46%,差异均有统计学意义(P<0.05)。结论脑出血破入脑室患者,经内镜下外科手术治疗能够较好地清除脑室内血肿,降低颅内感染率、再出血率和并发症发生率,改善预后。

Objective To explore the effect of endoscopic surgical treatment for intracerebral hemorrhage breaking into the ventricles.Methods 66 patients with intracerebral hemorrhage from January 2015 to January 2018 were selected as the study subjects.The patients were divided into control group(n=33)and observation group(n=33).The patients in the control group received routine microsurgical hematoma hematoma removal combined with ventriculo-drainage,while the patients in observation group received neuroendoscope-assisted brain parenchyma and intraventricular hematoma removal combined with tube drainage.The perioperative conditions,hematoma clearance,prognosis,and complications were compared between the two groups.Results There was no significant difference in the operation time between the two groups(P>0.05).The intracranial infection rate and rebleeding rate of the observation group were lower than those of the control group,and the GCS score was higher than that of the control group.The difference was statistically significant(P<0.05).There was no significant difference in the hematoma clearance rate of the brain parenchyma at the 1st,3rd,and 7th day after operation between the two groups(P>0.05).The intracerebral hematoma clearance rate of the observation group was higher than that of the control on the 1st,3 d,and 7 d postoperatively.In the group of patients,the difference was statistically significant(P<0.05).The rate of good prognosis in the observation group and the control group were 69.69%and 33.33%,respectively,and the total incidence of postoperative complications was 27.27%and 45.46%,respectively.The difference was statistically significant(P<0.05).Conclusion Endoscopic surgery for cerebral hemorrhage into the ventricle can better clear intraventricular hematoma,reduce intracranial infection rate,rebleeding rate and complication rate,and improve prognosis.