微创软通道技术治疗小脑及第四脑室出血的临床研究

目的探讨在治疗小脑及第四脑室出血时微创软通道技术的治疗效果。方法对2010年5月至2013年5月德州市市立医院收治的29例小脑及第四脑室出血患者采用微创软通道技术进行穿刺,分析患者的引流时间、清除血肿的比率、并发症的情况以及患者术后3个月后的生活质量,运用日常生活能力(ADL)评分法进行分级。结果引流时间在4²4 h的患者20例(68.97%);患者的清除率达到90%以上者18例(62.07%),清除率为80%24 h的患者20例(68.97%);患者的清除率达到90%以上者18例(62.07%),清除率为80%⁹0%者10例(34.48%),清除率为70%90%者10例(34.48%),清除率为70%⁸0%者1例(3.45%);发生了颅内感染患者3例(10.34%),无再出血、脑脊液漏、脑积水等其他并发症;治疗效果显著19例(65.5%);治疗有效7例(24.1%);治疗效果差3例(10.3%),总有效率为89.7%;随访3个月后,ADLⅠ级和Ⅱ级的患者19例(65.52%)。结论应用微创软通道技术行小脑和第四脑室穿刺,能够迅速降低压力,改善脑干的供血症状,降低病死率,提高患者生存质量,值得临床推广应用。

Clinical Study of Minimally Invasive Soft-channel Technology Treating Hemorrhage in Cerebellum and the Fourth Ventricle

Objective To investigate the minimally invasive soft-channel technology in the treatment of cerebellum and fourth ventricle hemorrhage.Methods A total of 29 cases of cerebellum and fourth ventricle hemorrhage admitted to Dezhou Municipal Hospital during May 2010 to May 2013 were punctured using minimally invasive soft-channel technology,and the drainage time,the rate of removal of the hematoma and postoperative complications of the patients were analyzed.Life quality after three months was assessed using ADL grading.Results Among the 20 cases （68.97%） with 4-24 h drainage treatment,clearance rate of 18 cases （62.07 %） was more than 90%,of 10 cases （34.48 %） was 80 %-90%,of one case（3.45 %） was 70 %-80%.Only 3 cases （10.34%） had intracranial infection,no further bleeding,cerebrospinal fluid leakage,hydrocephalus and other complications were found.Significant effect was observed in 19 cases（65.5 %）,and moderate effect was observed in 7 cases（24.1%）,and poor effect was observed in 3 cases（10.3 %）,together forming a total effective rate of 89.7%.Three months after surgery in 29 patients,during the viability of obsmvation,there were 19 cases（65.52%） of ADL Ⅰ and Ⅱ stage.Conclusion Minimally invasive softchannel technology using in treatment of cerebellum and fourth ventricle hemorrhage,can not only quickly reducestress and improve blood supply to the brain stem of the symptoms and reduce mortality in patients,but also improve the patientg quality of life,with promising application prospect in the clinical field.