神经内镜手术治疗脑室出血铸型的疗效分析

Efficacy of Neuroendoscopic Surgery in the Treatment ofIntraventricular Hemorrhage

目的 评价神经内镜手术在治疗脑室出血铸型的疗效。方法 分析60例脑室出血铸型病例的临床资料,经神经内镜脑室内血肿清除合并颅内压监测外引流手术组(内镜+引流组)30例,单纯颅内压监测外引流手术组(引流组)30例,比较2组病例血肿清除率、手术时间、术中失血量、引流管留置时间、住院天数、术后1周GCS评分。结果 2组病例术前临床资料差异无统计学意义(P> 0.05)。血肿清除率:内镜+引流组(98.4±1.1)%,引流组(50.1±5.4)%(P <0.05);手术时间:内镜+引流组:(51.1±6.5) min,引流组:(39.7±8.4) min(P <0.05);术中出血量:内镜+引流组(35.1±5.5) mL,引流组(31.1±4.4) mL(P> 0.05);引流管留置时间:内镜+引流组(2.5±1.3) d,引流组:(7.1±2.3) d(P <0.01);住院天数:内镜+引流组(7.5±2.1) d,引流组(14.2±1.3)d(P <0.01);术后1周GCS评分:内镜+引流组[(12.1±1.5),引流组(9.2±1.4), P <0.01]。结论 神经内镜手术能有效清除脑室积血铸型,明显改善患者预后。

Objective To evaluate the efficacy of neuroendoscopic surgery in the treatment of intraventricular hemorrhage.Methods The clinical data of 60 cases of intraventricular hemorrhage were analyzed,including 30 cases of endoscopic intracranial hematoma removal combined with intracranial pressure monitoring external drainage operation group(endoscope+drainage group)and 30 cases of intracranial pressure monitoring external drainage operation group(drainage group).The hematoma clearance rate,operation time,intraoperative blood loss,retention time of drainage tube,hospitalization days and GCS score 1 week after operation were compared between the two groups.Results There was no significant difference in preoperative clinical data between the two groups(P>0.05).The hematoma clearance rate was(98.4±1.1)%in the endoscopic+drainage group and(50.1±5.4)%in the drainage group(P<0.05).The operation time was(51.1±6.5)min in the endoscopic plus drainage group and(39.7±8.4)min in the drainage group(P<0.05).The intraoperative blood loss was(35.1±5.5)mL in the endoscopic plus drainage group and(31.1±4.4)mL in the drainage group(P>0.05).The indwelling time of drainage tube was(2.5±1.3)days in the endoscopic plus drainage group and(7.1±2.3)days in the drainage group(P<0.01).The length of hospital stay was(7.5±2.1)days in the endoscopic plus drainage group and(14.2±1.3)days in the drainage group(P<0.01).The 1-week postoperative GCS score was 12.1±1.5 in the endoscope-plus-drainage group and 9.2±1.4 in the drainage group(P<0.01).Conclusion Neu-roendoscopic surgery can effectively remove intraventricular hemorrhage and significantly improve the prognosis of patients.