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鹭嘴神经内镜鞘辅助神经内镜在高血压性脑室出血治疗中发挥着关键作用。

Heron-mouth neuroendoscopic sheath-assisted neuroendoscopy plays critical roles in treating hypertensive intraventricular hemorrhage.

作者信息

Xu Jie, Ma Siyuan, Wu Weijiang, Fang Wenfeng, Zhu Aihua, Ge Chun, Lu Hua

机构信息

Department of Neurosurgery, Affiliated Hospital of Jiangnan University (Wuxi Third People's Hospital), Wuxi, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):199-210. doi: 10.5114/wiitm.2020.99351. Epub 2020 Sep 25.

Abstract

INTRODUCTION

Neuroendoscopy is widely applied for treating hypertensive intracerebral hemorrhage.

AIM

To explore the effects of heron-mouth neuroendoscopic sheath-assisted neuroendoscopy on treatment of hypertensive intraventricular hemorrhage.

MATERIAL AND METHODS

A type of heron-mouth neuroendoscopic sheath combining the advantages of minimally invasive columnar endoscopic sheath and open operation methods was designed. The end of sheath catheter could be dilated if necessary, without increasing risk of cortex injury. Heron-mouth neuroendoscopic sheath-assisted neuroendoscopy was applied in treatment of hypertensive intraventricular hemorrhage. A total of 19 patients with hypertensive intraventricular hemorrhage were selected and divided into an external ventricular drainage + urokinase group and a neuroendoscopy group. Hematoma clearance rate, surgical time, ventricular drainage time, intracranial infection, hydrocephalus and Glasgow Outcome Score (GOS) at 3 months after the operation were compared between two groups.

RESULTS

Hematoma clearance rate, ventricular drainage time, mortality rate and GOS at 3 months after surgery in the neuroendoscopy group were significantly better compared to those in the external ventricular drainage + urokinase group (p < 0.05). Postoperative complications, including intracranial infection hydrocephalus and pulmonary infection in the neuroendoscopy group, were less numerous compared to those in the external ventricular drainage + urokinase group, but without statistical significance (p > 0.05). However, surgical time was significantly longer in the neuroendoscopy group compared to that in the external ventricular drainage + urokinase group (p < 0.05). There was no significant difference in incidence rate of hydrocephalus between the two groups (p > 0.05).

CONCLUSIONS

Clinical effects of heron-mouth neuroendoscopic sheath-assisted neuroendoscopy were better than those of external ventricular drainage combining urokinase dissolution in treating hypertensive intraventricular hemorrhage.

摘要

引言

神经内镜广泛应用于高血压性脑出血的治疗。

目的

探讨鹭嘴神经内镜鞘辅助神经内镜治疗高血压性脑室出血的效果。

材料与方法

设计一种兼具微创柱状内镜鞘和开放手术方法优点的鹭嘴神经内镜鞘。鞘导管末端必要时可扩张,且不增加皮质损伤风险。采用鹭嘴神经内镜鞘辅助神经内镜治疗高血压性脑室出血。选取19例高血压性脑室出血患者,分为脑室外引流+尿激酶组和神经内镜组。比较两组术后血肿清除率、手术时间、脑室引流时间、颅内感染、脑积水及术后3个月的格拉斯哥预后评分(GOS)。

结果

神经内镜组术后血肿清除率、脑室引流时间、死亡率及术后3个月的GOS均明显优于脑室外引流+尿激酶组(p<0.05)。神经内镜组术后并发症,包括颅内感染、脑积水及肺部感染,较脑室外引流+尿激酶组少,但差异无统计学意义(p>0.05)。然而,神经内镜组手术时间明显长于脑室外引流+尿激酶组(p<0.05)。两组脑积水发生率差异无统计学意义(p>0.05)。

结论

鹭嘴神经内镜鞘辅助神经内镜治疗高血压性脑室出血的临床效果优于脑室外引流联合尿激酶溶解术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b38/7991947/9573bdbab778/WIITM-16-41896-g001.jpg

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