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脑室内神经内镜手术中严重术中出血的处理：干燥术野技术。

Management of severe intraoperative hemorrhage during intraventricular neuroendoscopic procedures: the dry field technique.

机构信息

Klinik für Neurochirurgie, Universität des Saarlandes, Homburg, Saar, Germany.

Universität des Saarlandes, Kirrberger Straße 1, Gebäude 90.5, 66424, Homburg, Germany.

出版信息

Acta Neurochir (Wien). 2022 Oct;164(10):2551-2557. doi: 10.1007/s00701-022-05207-9. Epub 2022 Apr 22.

DOI:10.1007/s00701-022-05207-9
PMID:35449360
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9519719/
Abstract

OBJECTIVE

Neuroendoscopic procedures inside the ventricular system always bear the risk for an unexpected intraoperative hemorrhage with potentially devastating consequences. The authors present here their experience, and a stage-to-stage guide for the endoscopic management of intraoperative hemorrhages.

METHODS

A step-by-step guide for the management to gain control of and stop the bleeding is described including a grading system. More advanced techniques are presented in cases examples.

CONCLUSION

Most of intraoperative hemorrhages can be controlled by constant irrigation and coagulation. More advanced techniques can be applied quickly and easily to ensure control of the hemorrhages and avoid the need for a microsurgical conversion.

摘要

目的

脑室系统内的神经内镜手术始终存在术中意外出血的风险，可能导致灾难性后果。作者在此介绍他们的经验，以及内镜处理术中出血的分阶段指南。

方法

描述了一种逐步控制和止血的管理指南，包括分级系统。在病例示例中介绍了更先进的技术。

结论

大多数术中出血可通过持续冲洗和凝固来控制。更先进的技术可以快速、轻松地应用，以确保出血得到控制，避免需要转为显微手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/ec3c1b38e676/701_2022_5207_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/cd74c5f23bcc/701_2022_5207_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/12ae5b512a4d/701_2022_5207_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/11c6a17597df/701_2022_5207_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/99f6a4d8a767/701_2022_5207_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/ec3c1b38e676/701_2022_5207_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/cd74c5f23bcc/701_2022_5207_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/12ae5b512a4d/701_2022_5207_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/11c6a17597df/701_2022_5207_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/99f6a4d8a767/701_2022_5207_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acc3/9519719/ec3c1b38e676/701_2022_5207_Fig5_HTML.jpg

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J Neurosurg. 2018 Sep 21;131(3):931-935. doi: 10.3171/2018.4.JNS172537. Print 2019 Sep 1.
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World Neurosurg. 2017 Dec;108:817-825. doi: 10.1016/j.wneu.2017.09.045. Epub 2017 Sep 18.
3
The small-chamber irrigation technique (SCIT): a simple maneuver for managing intraoperative hemorrhage during endoscopic intraventricular surgery.
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Neuroendoscopic resection of intraventricular tumors: a systematic outcomes analysis.神经内镜下切除脑室内肿瘤：系统的疗效分析
Minim Invasive Surg. 2013;2013:898753. doi: 10.1155/2013/898753. Epub 2013 Sep 26.
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Endoscopic third ventriculostomy: preoperative considerations and intraoperative strategy based on 300 procedures.内镜下第三脑室造瘘术：基于300例手术的术前考量及术中策略
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