Cai Qiang, Guo Qiao, Li Zhiyang, Wang Wenju, Zhang Wenfei, Ji Baowei, Chen Zhibiao, Liu Jun
Department of Neurosurgery, Renmin Hospital of Wuhan University, Hubei Province, People's Republic of China,
Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China,
Neuropsychiatr Dis Treat. 2019 Apr 11;15:919-925. doi: 10.2147/NDT.S195275. eCollection 2019.
Spontaneous supratentorial intracerebral hemorrhage (SSICH) is one of the deadliest diseases, and neuroendoscopic surgery (NE) is a minimally invasive and promising treatment that might improve the functional recovery of patients. This study analyzed patient's experience with this treatment in terms of safety, efficacy, and surgical technique.
Forty-two patients with SSICHs treated by transcranial neuroendoscopic approach were retrospectively reviewed from June 2016 to July 2018 in our department. Patients were classified into four groups according to the main location of the hematoma on CT scans: Group A (basal ganglia hemorrhage), Group B (subcortical hemorrhage), Group C (thalamic hemorrhage), and Group D (intraventricular hemorrhage [IVH]). The clinical data were collected, and the outcomes were analyzed.
All procedures were successfully completed, and no patient died in the perioperative period. The average hematoma evacuation rate was 90.1%, and the highest hematoma evacuation rate was achieved in Group B which was 92.7%. No severe complications occurred, and the average GCS score improvement was 4.0 at discharge.
These data suggest that evacuation hemorrhage by neuroendoscopy might be an effective and safe approach for SSICH. For better efficiency of this treatment, some details needed to be emphasized, such as setting up a good working channel, using of suction and bipolar forceps accurately.
自发性幕上脑出血（SSICH）是最致命的疾病之一，神经内镜手术（NE）是一种微创且有前景的治疗方法，可能改善患者的功能恢复。本研究从安全性、有效性和手术技术方面分析了患者接受该治疗的体验。
回顾性分析2016年6月至2018年7月在我科采用经颅神经内镜方法治疗的42例SSICH患者。根据CT扫描血肿的主要位置将患者分为四组：A组（基底节区出血）、B组（皮质下出血）、C组（丘脑出血）和D组（脑室内出血[IVH]）。收集临床资料并分析结果。
所有手术均成功完成，围手术期无患者死亡。平均血肿清除率为90.1%，B组血肿清除率最高，为92.7%。未发生严重并发症，出院时平均格拉斯哥昏迷量表（GCS）评分提高4.0分。
这些数据表明，神经内镜下清除血肿可能是治疗SSICH的一种有效且安全的方法。为提高该治疗的效率，需要强调一些细节，如建立良好的工作通道、准确使用吸引器和双极电凝镊。
