Komatsu Fuminari, Komatsu Mika, Wakuta Naoki, Oshiro Shinaya, Tsugu Hitoshi, Iwaasa Mitsutoshi, Inoue Tooru
Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Neurol Med Chir (Tokyo). 2010;50(11):972-6. doi: 10.2176/nmc.50.972.
The efficacy of treatment for intraventricular hematoma by neuroendoscopic surgery and extraventricular drainage was compared in 10 patients with intraventricular hematoma and hydrocephalus who underwent neuroendoscopic surgery (endoscopic group), and eight patients with intraventricular hematoma and hydrocephalus treated with extraventricular drainage (EVD group). The outcomes in each group were assessed retrospectively using the Graeb scores on the pre- and postoperative computed tomography (CT), duration of extraventricular drainage, requirement for a shunt operation, and modified Rankin scale score at 12 months. The Graeb scores on the preoperative CT were not significantly different between the two groups, but the duration of catheter placement was significantly shorter (69.3%) in the endoscopic group (2.7 days) than in the EVD group (8.8 days). None of the patients in either group required a shunt procedure for communicating hydrocephalus 12 months after surgery. Neuroendoscopic removal is a safe and effective procedure for intraventricular hematoma. Advantages include rapid removal of hematoma in the ventricular systems and reliable improvement of non-communicating hydrocephalus in the acute phase. The procedure resulted in faster removal of the catheter in the postoperative period and earlier patient ambulation.
对10例患有脑室内血肿和脑积水且接受神经内镜手术的患者（内镜组）以及8例接受脑室外引流治疗的脑室内血肿和脑积水患者（脑室外引流组，EVD组），比较了神经内镜手术和脑室外引流治疗脑室内血肿的疗效。使用术前和术后计算机断层扫描（CT）上的Graeb评分、脑室外引流持续时间、分流手术需求以及12个月时的改良Rankin量表评分对每组结果进行回顾性评估。两组术前CT上的Graeb评分无显著差异，但内镜组（2.7天）的置管时间明显短于EVD组（8.8天）（短69.3%）。术后12个月，两组均无患者因交通性脑积水需要进行分流手术。神经内镜清除术是治疗脑室内血肿的一种安全有效的方法。优点包括快速清除脑室系统内的血肿以及在急性期可靠地改善非交通性脑积水。该手术在术后能更快地拔除导管，患者能更早下地活动。
