小骨窗开颅内镜辅助下手术治疗3种不同部位高血压脑出血的研究

Small bone window endoscopic-assisted surgery for treatment types of hypertensive cerebral hemorrhage in three different locations

目的研究小骨窗开颅内镜辅助下手术治疗3种不同部位高血压脑出血的疗效及优势。方法采用西海岸新区中心医院开展的小骨窗开颅内镜辅助下血肿清除术治疗高血压脑出血患者110例。脑出血包括基底节区、小脑、脑室内出血,其中基底节区出血患者中发生脑疝者4例。30例患者平时口服阿司匹林,6例患者用氯吡格雷及阿司匹林双抗。术后3个月时进行疗效评价,根据ADL日常生活能力评定量表评分。结果本组患者预后良好率为95.05%;其中基底节区出血患者的预后良好率为93.47%,小脑出血患者预后良好率为91.67%,脑室内出血患者预后良好率为100%。4例基底节出血脑疝患者术后1周内无1例死亡。结论采用小骨窗开颅内镜辅助下进行不同部位高血压脑出血的手术治疗术式,充分体现了内镜技术用于高血压脑出血手术的可行性及优势。对口服抗血小板、抗凝药物及脑疝患者进行小骨窗开颅内镜辅助下脑内血肿清除术也是可行的,并且手术效果良好。

Objective To study the efficacy and advantages of small bone window endoscopic assisted surgery for three kinds of hypertensive cerebral hemorrhage in different parts.Methods 110 patients with hypertensive intracerebral hemorrhage were treated by small bone window endoscopic assisted hematoma removal by the West Coast New District Central Hospital.Cerebral hemorrhage included hemorrhage in the basal ganglia,cerebellum,and intraventricular hemorrhage,of which 4 patients had cerebral hernia in patients with basal ganglia hemorrhage.30 patients usually took aspirin orally,and 6 received clopidogrel and aspirin.The curative effect was evaluated at 3 months after operation,according to the ADL Daily Living Ability Rating Scale.Results The good prognosis rate of this group of patients was 95.05%,the good prognosis rate of patients with basal ganglia hemorrhage was 93.47%,the good prognosis rate of patients with cerebellar hemorrhage was 91.67%,and the good prognosis rate of patients with intraventricular hemorrhage was 100%.None of the 4 patients with basal ganglia hemorrhage and cerebral hernia died within 1 week after operation.Conclusions The surgical treatment of hypertensive intracerebral hemorrhage at different locations with small bone window endoscopy fully reflects the feasibility and advantages of endoscopic technique for hypertensive intracerebral hemorrhage surgery.Small bone window endoscopic assisted intracerebral hematoma removal is also feasible for patients with oral antiplatelet,anticoagulant drugs and cerebral hernia,and the surgical effect is good.