脑室铸型血肿的软性神经内镜治疗

目的 探讨应用软性神经内镜治疗脑室铸型血肿的疗效.方法 回顾性分析2014年5月～2016年1月航空总医院神经外科采用软性神经内镜治疗11例脑室铸型血肿患者的临床资料.评估手术时间、术后脑室外引流时间,额外的脑脊液分流手术,术后3个月结果和相关并发症.结果 在发病后第4天和第5天接受软性神经内镜手术的2例患者需要随后的脑脊液分流手术.相比之下,在发病当天接受内镜手术的9例患者中,只有1例患者因为纤维粘连导致继发性梗阻,需要额外行第三脑室底造瘘术.术后3个月,所有6例mRS评分为2～3分的患者符合以下标准:初始格拉斯哥昏迷评分高于8分,在发病当天接受软性神经内镜手术,并且脑室外引流时间小于4d.结论 使用软性神经内镜早期干预和术后短时间脑室外引流对于脑室铸型血肿效果较好.

Flexible endoscopic treatment of intraventricular casting hematoma

Objective To investigate the effect of flexible endoscopic treatment on intraventricular casting hematoma.Methods Clinical data of 11 patients with intraventricular casting hematoma treated with flexible endoscopy at the Department of Neurosurgery,Aviation General Hospital from May 2014 to January 2016 were analyzed retrospectively.The operative time,post-endoscopic ventricular drainage time,additional CSF shunt surgery,3-month post-surgical outcome and related complications were evaluated.Results Two patients who underwent flexible endoscopic surgery on the 4th and 5th day after the onset required additional CSF shunt surgery.In contrast,of the 9 patients who underwent endoscopic surgery on the day of onset,only 1 patient required an additional third ventriculostomy due to secondary obstruction of the aqueduct caused by fibrous adhesion.After 3 months,all 6 patients with mRS scores of 2-3 satisfied all the following criteria:with initial Glasgow Coma Scale scores higher than 8,taken flexible endoscopic surgeries on the day of onset,and with ventricular drainage time of less than 4 d.Conelusions Early flexible endoscopic treatment and ventricular drainage in short time post-surgery are highly effective for patients with intraventricular casting hematomas.