神经内窥镜治疗原发性脑室出血

目的：探讨用微创技术治疗原发性脑室出血的新方法。方法：应用Karl-Storz硬质神经内窥镜治疗原发性脑室出血31例,其中单侧侧脑室为主的出血16例,双侧侧脑室为主的出血14例,三脑室合并四脑室出血1例。并发急性梗阻性脑积水者24例。结果：手术时间30-60min,平均43.4min。24例单、双侧脑室血肿清除90％以上,其余7例血肿清除50％-90％。术后明显好转和好转25例,无变化4例,死亡2例。1例术后并发脑积水。结论：应用神经内窥镜清除脑室内血肿,具有直视下操作、手术时间短、创伤小、血肿清除率高和术后疗效好等优点。

Neuroendoscopic neurosurgy for primary intraventricular hemorrhage

Objective To investigate the new therapy for primary intraventricular hemorrhage (PIH).Methods 31 cases of PIH were treated by rigid neuroendoscopy.The cases were composed of 16 cases of single intraventricular hemorrhage,14 cases of double intraventricular hemorrhage and 1 case the third-fourth intraventricular hemorrhage.24 cases were accompanied with acute obstructive hydrocephalus.Results Duration of operation lasted from 30 minutes to 60 minutes, with an average time of 43.4 minutes.More than 90 percent of hemorrhage in 24 cases with single or double intraventricular hemorrhage were evacuated. 50 percent to 90 percent of hemorrhage were evacuated in other 7 cases. Neurological status was obviously improved and improved in 25 cases, no change in 4 cases and dead in 2 cases.Only one patient developed hydrocephalus.Conclusion Neuroendoscopic neurosurgy for PIH was characterized by visualized manipulation, shorten operative time,minimal invasion, effective hemorrhage evacuation and excellent post-operative outcomes.