自制鹭嘴式神经内镜鞘辅助神经内镜手术治疗高血压性脑室出血

目的 探讨自制鹭嘴式神经内镜鞘辅助神经内镜手术治疗高血压性脑室出血的疗效。方法 回顾性分析2013年1月至2018年1月收治的63例高血压性脑室出血的临床资料。在鹭嘴式神经内镜鞘辅助下神经内镜手术治疗21例（内镜组），单纯脑室外引流术治疗42例（引流组）。结果 内镜组术后血肿清除<60%有1例，60%~90%有9例，>90%有11例；引流组术后血肿清除<60%有40例，60%~90%有1例，>90%有1例；内镜组血肿清除率明显优于引流组（P<0.01）。内镜组术后并发症发生率（4.76%，1/21）明显低于引流组（30.96%，13/42；P<0.05)。术后 6个月，内镜组预后良好率（85.71%，18/21；ADL分级Ⅰ~Ⅲ级）明显高于引流组（52.38%，22/2；P<0.05）。结论 对于高血压性脑室出血，自制鹭嘴式神经内镜鞘能扩大操作空间，可提高神经内镜手术血肿清除率，减少并发症，明显改善病人预后

Endoscopic surgery assisted by self- made egret's besky neuroendoscopic sheath for hypertensive intraventricular hemorrhage

Objective To explore the clinical effect of endoscopic surgery assisted by self- made egret's besky neuroendoscopic sheath on hypertensive ventricular hemorrhage (HVH). Methods The clinical data of 63 patients with HVH who were admitted to our hospital from January 2013 to January 2018 were retrospectively analyzed. Of these 63 patients, 21 patients were treated with endoscopic surgery assisted by self- made egret's besky neuroendoscopic sheath (endoscopy group), and 42 were treated with extraventricular drainage (drainage group). Results The postoperative hematoma clearance rates <60%, 60%~90%, and >90% were achieved in 1, 9, and 11 patients in the endoscopy group, and in 40, 1 and 1 patients in the drainage group, respectively. The hematoma clearance rate in the endoscopic group was significantly better than that in the drainage group (P<0.01). The incidence of postoperative complications in the endoscopic group (4.76%, 1/21) was significantly lower than that in the drainage group (30.96%, 13/42; P<0.05). Six months after surgery, the good rate of prognosis in the endoscopic group (85.71%, 18/21; ADL grades Ⅰ~Ⅲ) was significantly higher than that in the drainage group (52.38%, 22/42; P<0.05). Conclusions For HVH, self- made egret's besky neuroendoscopic sheath can expand the operation space in order to improve the clearance rate of hematoma during neuroendoscopic surgery, reduce the complications and significantly improve the prognosis of patients