神经内镜下微创手术治疗丘脑出血破入脑室的疗效分析

Efficacy analysis on neuroendoscopic microsurgery in treatment of thalamic hemorrhage extended into ventricles

目的探讨神经内镜辅助下微创手术治疗丘脑出血破入脑室的应用价值。方法回顾性分析65例丘脑出血并破入脑室患者的临床资料,依据手术方式分为神经内镜+脑室外引流组(30例)与单纯脑室外引流组(35例)。对两组患者的疗效、手术安全性及预后指标进行分析比较。结果与单纯脑室外引流组比较,神经内镜+脑室外引流组患者的血肿清除率明显增高,术后引流管留置时间明显缩短,术后再出血率、脑积水发生率、颅内感染和肺部感染率明显降低,差异均有统计学意义(P<0.05)。神经内镜+脑室外引流组患者术后6个月的预后良好率显著高于单纯脑室外引流组,差异有统计学意义(P<0.05)。结论对于丘脑出血破入脑室患者,神经内镜微创手术在提高血肿清除率、缩短引流管留置时间、减少术后并发症、改善预后方面较单纯脑室外引流术具有更大优势。

Objective To investigate the application value of microsurgery assisted by neuroendoscope in the treatment of thalamic hemorrhage extended into ventricles.Methods The clinical data of 65 patients with thalamic hemorrhage extended into ventricles were retrospectively analyzed.The patients were divided into the neuroendoscopy+extraventricular drainage group(30 cases)and merely extraventricular drainage group(35 cases).The efficacy,surgical safety and prognostic indexes were analyzed in the two groups.Results Compared with those in the merely extraventricular drainage group,patients in the neuroendoscopy+extraventricular drainage group had significantly higher hematoma clearance rate,shorter time of carrying tube,and lower incidence of postoperative rebleeding,hydrocephalus,intracranial infection and pulmonary infection(P<0.05).The rate of good prognosis in the neuroendoscopy+extraventricular drainage group at 6 months after operation was significantly higher than that in the merely extraventricular drainage group(P<0.05).Conclusion Neuroendoscopic surgery for treating thalamic hemorrhage extended into ventricles has advantages in improving hematoma clearance rate,shortening catheterization time,reducing postoperative complications and improving prognosis.