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神经内镜在脑室出血治疗中的应用。

Application of neuroendoscopy in the treatment of intraventricular hemorrhage.

作者信息

Zhang Zaiqiang, Li Xingang, Liu Yuguang, Shao Yi, Xu Shujun, Yang Yang

机构信息

Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, PR China.

出版信息

Cerebrovasc Dis. 2007;24(1):91-6. doi: 10.1159/000103122. Epub 2007 May 23.

Abstract

BACKGROUND

Spontaneous intraventricular hemorrhage is an infrequent but severe complication of hemorrhagic stroke. The conventional treatment of intraventricular hemorrhage consists of ventricular drainage or surgical evacuation, but neither of them is encouraged. The objective of this article is to compare different surgical procedures in order to evaluate a method of minimally invasive treatment for intraventricular hemorrhage.

METHODS

Neuroendoscopy was applied to treat 22 cases of intraventricular hemorrhage. Twenty cases of the same disease that were treated by external ventricular drainage were taken as a control and comparison.

RESULTS

All patients were followed up for 2 months. In the neuroendoscopy group, according to the Glasgow outcome scale, the result was excellent in 5 cases, good in 9, fair in 4, poor in 2 and death in 2. In the external ventricular drainage group, the result was excellent in 1 case, good in 5, fair in 7, poor in 5 and death in 2. More patients in the neuroendoscopy group showed good recovery after 2 months of surgery (p < 0.05). The difference in mortality rate between the 2 groups was not statistically significant (p > 0.05).

CONCLUSIONS

Neuroendoscopic neurosurgery for intraventricular hemorrhage offers better surgical treatment because it is characterized by visualized manipulation, effective hemorrhage evacuation and excellent postoperative outcomes.

摘要

背景

自发性脑室内出血是出血性卒中一种少见但严重的并发症。脑室内出血的传统治疗方法包括脑室引流或手术清除血肿,但这两种方法都不被提倡。本文的目的是比较不同的手术方法,以评估一种脑室内出血的微创治疗方法。

方法

应用神经内镜治疗22例脑室内出血患者。选取20例采用脑室外引流治疗的同疾病患者作为对照和比较对象。

结果

所有患者均随访2个月。神经内镜组中,根据格拉斯哥预后量表,结果为优5例,良9例,中4例,差2例,死亡2例。脑室外引流组中,结果为优1例,良5例,中7例,差5例,死亡2例。神经内镜组更多患者术后2个月恢复良好(p<0.05)。两组死亡率差异无统计学意义(p>0.05)。

结论

神经内镜手术治疗脑室内出血提供了更好的手术治疗方式,因为其特点是操作可视化、有效清除血肿及术后效果良好。

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