实用医学杂志 ›› 2021, Vol. 37 ›› Issue (23): 3003-3007.doi: 10.3969/j.issn.1006⁃5725.2021.23.009

• 临床研究 • 上一篇    下一篇

神经内镜手术对重型脑室出血患者的临床疗效

周和平1 查正江1 王雷2 陈敏1 张清超1 唐剑1   

  1. 安徽医科大学附属安庆医院1 神经外科,2 神经内科(安徽安庆 246003)

  • 出版日期:2021-12-10 发布日期:2021-12-10
  • 基金资助:
    安徽省科技重大专项基金(编号:201903a07020006);安徽医科大学校临床科学研究基金(编号:2019xkj225)

Clinical effect of neuroendoscopic surgery on patients with severe intraventricular hemorrhage

ZHOU Heping*,ZHA Zhengjiang,WANG Lei,CHEN Min,ZHANG Qingchao,TANG Jian.   

  1. Department of Neurosurgery Anqing Hospital affiliated to Anhui Medical University,Anqing 246003,China

  • Online:2021-12-10 Published:2021-12-10

摘要:

目的 探讨神经内镜手术对重型脑室出血患者的临床疗效和安全性。方法 选取 2019 1 月至 2021 5 月安徽医科大学附属安庆医院神经外科手术治疗的 96 例重型脑室出血患者,其中经神经 内镜手术 49 例,单纯脑室外引流手术 47 例。比较分析两组患者住院时间、术后 GCS 评分、术后血肿 清除程度、预后和相关并发症。结果 神经内镜组和单纯脑室外引流组血肿清除率、术后住院时间、颅内感染和术后第 1、14 GCS 评分比较差异均有统计学意义(P < 0.05)。术后随访 6 个月,ADL 评分神经 内镜组预后良好 35 例(71.42%),脑积水 5 例(10.20%)。脑室外引流组预后良好 18 例(38.29%),脑积水 19 例(40.42%)。神经内镜组预后良好率、脑积水发生率明显好于脑室外引流组,差异有统计学意义 P < 0.05)。结论 神经内镜手术治疗重型脑室出血具有良好的疗效,可改善患者临床预后及转归,适合临床推广。

关键词:

重型脑室出血,  , 神经内镜,  , 脑室外引流,  , 手术治疗,  , 临床疗效

Abstract:

Objective To study the clinical efficacy and safety of neuroendoscopic surgery in the treat⁃ ment of severe intraventricular hemorrhage. Methods From January 2019 to May 2021,96 patients with severe intraventricular hemorrhage were treated in the department of neurosurgery in Anqing Hospital,Anhui Medical University,49 of them treated with neuroendoscopic surgery and 47 with simple extraventricular drainage. The two groups were compared in terms of hospital stay,postoperative GCS score,postoperative clearance of hematoma, prognosis and complications. Results There were statistically significant differences in the hematoma clearance rate,postoperative hospital stay,intracranial infection and GCS score on the 1st and 14th day after surgery between the two group(< 0.05). After 6 months follow⁃up,the prognosis of 35 cases(71.42%)in the neuroendoscopy group was good by the ADL score and there were 5 cases of hydrocephalus in the group(10.20%);while the prognosis of18 cases(38.29%)in the extraventricular drainage group was good and there were19 cases(40.42%)of hydro⁃ cephalus in the group. The rate of good prognosis and incidence of hydrocephalus in the neuroendoscopy group were significantly better than those in the extraventricular drainage group(< 0.05). Conclusion Neuroendoscopic surgery has good curative effect on severe intraventricular hemorrhage. It can improve the clinical prognosis and out⁃ come of patients,and is suitable for clinical promotion. 

Key words: severe ventricular hemorrhage,  , neuroendoscopy,  , extraventricular drainage,  , surgical treatment,  , clinical efficacy