透明管鞘下针式内镜辅助手术治疗高血压脑出血的临床研究

目的探讨透明管鞘下针式内镜在高血压脑出血微创手术中的应用效果.方法总结分析采用透明管鞘为支撑通道,针式内镜辅助手术治疗的35例高血压脑出血患者的临床资料.结果35例患者术后头颅CT示血肿完全清除25例,近全部清除6例,大部分清除4例.手术平均时间2.3h.除1例患者术后再出血行二次内镜清除外,其余患者均无术后再出血发生.术后随访6个月, GOS分级Ⅴ级14例,Ⅳ5例,Ⅲ级10例,Ⅱ级5例,Ⅰ级1例.结论以透明管鞘为支撑通道,针式内镜下行高血压脑出血血肿清除手术具有可直视下清除血肿,视野清晰开阔,手术耗时短,对周围组织损伤小,血肿清除率高,术后再出血率低等优点.

Needlescope-assisted neurosurgery through transparent sheath for hypertensive intracerebral hemorrhage

Objective To explore the application of needlescope-assisted neurosurgery through transparent theath treating hypertensive intracerebral hemorrhage（HICH）. Method The clinical data of 35 patients with HICH who underwent neediescope-assisted neurosurgery through transparent sheath were analyzed retrospectively. Results Postoperative CT showed that the total evacuation of haematomas was reached in 25 patients, subtotal evacuation in 6 and greatly part evacuated in 4. The mean operation time was 2.3 hours.There were no postoperative rebleeding in all patients except one who was underwent needlescope-assisted neurosurgery again for the rebleeding. The prognoses were assessed by GOS during following up period of 6 months after the surgery. Of 35 patients, 14 belonged in GOS grade V, 5 in grade IV, 10 in grade m, 5 in grade Ⅱ , 1 in grade I . Conclusion The needlescope-assisted neurosurgery through transparent theath treating HICH has the advantages including directly haematomas evacuating, wide visual field, short operation time, slight surgery-side injury, high haematomas evacuation rate and fewer postoperative rebleeding rate.