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内镜下清除高血压性脑出血的经验

Experience of endoscopic removal of hypertensive intracerebral hemorrhage.

作者信息

Gushcha A O, Semenov M S, Lepsveridze L T

机构信息

Scientific Center of Neurology, Moscow, Russia.

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 2015;79(6):71-76. doi: 10.17116/neiro201579671-76.

Abstract

AIM

This study was aimed at assessing the efficacy of endoscopic technique in surgery for hypertensive intracerebral hemorrhage.

MATERIAL AND METHODS

This paper focus on our experience (11 cases) of endoscopic removal of hypertensive intracerebral hemorrhage. The paper presents examples of endoscopic removal of hematomas located in the basal ganglia (9 cases) and in the posterior fossa (2 cases), causing occlusion at the fourth ventricle. In 3 patients (27%) with intraventricular hemorrhage, the removal of acute hematomas from the ventricular system with simultaneous endoscopic triple ventriculostomy was performed. Intervention was carried out within the first 6 hours in patients with hemispheric hematomas (in 90% of cases) and within 3-5 hours in patients with PCF hematomas.

RESULTS

The article analyzes the functional outcomes in the early and late postoperative period. Complete regression of neurological symptoms was achieved in 4 (36%) patients and the remaining 7 (64%) patients had a moderate disability at discharge.

CONCLUSION

In our opinion, endoscopic removal of hypertensive intracerebral hemorrhage is a promising method that meets all existing aspects of modern neurosurgery. The combination of rigid and flexible endoscopy provides new capabilities in surgery of patients with intraventricular hemorrhage.

摘要

目的

本研究旨在评估内镜技术在高血压脑出血手术中的疗效。

材料与方法

本文重点介绍我们(11例)内镜下清除高血压脑出血的经验。文中展示了内镜下清除位于基底节区(9例)和后颅窝(2例,导致第四脑室梗阻)血肿的实例。在3例(27%)脑室出血患者中,进行了从脑室系统清除急性血肿并同时行内镜下三脑室造瘘术。半球血肿患者在6小时内(90%的病例)进行干预,后颅窝血肿患者在3 - 5小时内进行干预。

结果

本文分析了术后早期和晚期的功能结局。4例(36%)患者神经症状完全消退,其余7例(64%)患者出院时中度残疾。

结论

我们认为,内镜下清除高血压脑出血是一种有前景的方法,符合现代神经外科的所有现有要求。硬性和软性内镜的结合为脑室出血患者的手术提供了新的能力。

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