[1]任峰,卞杰勇,王晓军,等.内镜手术治疗脑室出血伴脑室铸型的疗效分析[J].临床神经外科杂志,2019,16(5):454-457.[doi:10.3969/j.issn.1672-7770.2019.05.019]
 REN Feng,BIAN Jie-yong,WANG Xiao-jun,et al.Analysis of endoscopic microsurgery combined with external ventricular drainage plus ICP monitoring for severe ventricular hemorrhage[J].Journal of Clinical Neurosurgery,2019,16(5):454-457.[doi:10.3969/j.issn.1672-7770.2019.05.019]
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内镜手术治疗脑室出血伴脑室铸型的疗效分析 ()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第5期
页码:
454-457
栏目:
临床研究
出版日期:
2019-10-15

文章信息/Info

Title:
Analysis of endoscopic microsurgery combined with external ventricular drainage plus ICP monitoring for severe ventricular hemorrhage
作者:
任峰卞杰勇王晓军路阳于涛周林强石磊周岱
215006 苏州,苏州市相城人民医院神经外科(任峰,卞杰勇,王晓军,路阳,于涛,周林强,石磊);苏州大学附属第一医院神经外科(周岱)
Author(s):
REN Feng BIAN Jie-yong WANG Xiao-junet al.
Department of Neurosurgery, Xiangcheng People's Hospital of Suzhou,Suzhou 215006,China
关键词:
神经内镜颅内压监测脑室出血手术脑室外引流
Keywords:
endoscope ICP monitoring ventricular hemorrhage microsurgery external ventricular drainage
分类号:
R743.34
DOI:
10.3969/j.issn.1672-7770.2019.05.019
文献标志码:
D
摘要:
【摘要】目的 研究内镜手术结合颅内压监测引流系统在严重丘脑出血破入脑室治疗中的作用。方法观察20例严重丘脑出血破入脑室患者经内镜手术并结合强生颅内压监测引流(内镜+引流组)治疗的效果,并与前期17例单纯钻颅脑室外引流手术患者(单纯引流组)进行对比分析;比较两种手术术后不同时间段第三、四脑室内积血残留量,术后并发症发生率,以及术后6个月时日常生活能力(Ability in Daily Life,ADL)评分。结果内镜+引流组患者术后第1 d、4 d、7 d、10 d复查头颅CT三、四脑室积血量明显少于单纯引流组(均P<0.05),后期交通性脑积水发生率也明显少于单纯引流组(P<0.05)。两组其他并发症(肺部感染、术后再出血、颅内感染等)发生率的差异无统计学意义(均P>0.05)。内镜+引流组术后6月时ADL评分良好率为75%(15/20),单纯引流组良好率为35.3%(6/17),内镜+引流组的良好率明显高于单纯引流组(P<0.05)。结论内镜手术结合颅内压监测引流治疗严重丘脑出血破入脑室,具有微创、安全、血肿清除相对彻底、术后并发症少等特点,可明显改善患者的预后。
Abstract:
Abstract: ObjectiveTo investigate the effect of endoscope microsurgery combined with external ventricular drainage plus ICP monitoring for severe intra-ventricular hemorrhage. MethodsTo analyze the effect of 20 cases of endoscope microsurgery combined with external ventricular drainage plus ICP monitoring system for severe intra-ventricular hemorrhage(EN+DR group)after June 2015,and to compare with that of 17 cases of only ventricular puncture with external drainage (DR group)from January 2014 to June 2015. Hemorrhage volume before surgery, residual hemorrhage volume of different times in 3rd,4th ventricles,complication occurrence rate,ADL score after 6 months of two groups were compared. ResultsHemorrhage volume before surgery in both groups were statistically insignificant(P>0.05). Residual hemorrhage volume at 24 h, 4 days, 7 days, 10 days in 3th 、4th ventricles in EN+DR group was much less than that of TN group(all P<0.05). Among all the complications including pulmonary infection,digestive bleeding etc,only hydrocephalus occurrence rate in EN+DR group were fewer than that of DR group(P<0.05). 6 months after operation, in EN+DR group, 2 cases of ADL grade Ⅰ, 6 cases of ADL grade Ⅱ, 7 cases of ADL grade Ⅲ, 3 cases of ADL grade Ⅳ, 2 case of ADL grade Ⅴ, good recovery rate was 75.0%. In DR group, 1 cases of ADL grade , 2 cases of ADL grade Ⅱ, 3 cases of ADL grade Ⅲ, 8 cases of ADL grade Ⅳ, 3 case of ADL grade Ⅴ, good recovery rate was 35.3%, the difference was statistically significant(P<0.05 ). ConclusionThe endoscope microsurgery combined with external ventricular drainage plus ICP monitoring is more effective to treat severe thalamic hemorrhage and can significantly improve the prognosis of patients.

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更新日期/Last Update: 2019-10-15