神经内镜治疗丘脑出血破入脑室的疗效分析

目的 探讨神经内镜下治疗丘脑出血(thalamus hemorrhage)对比传统单纯脑室外引流治疗丘脑脑出血的临床手术及预后效果.方法 选择2011年3月至2014年1月CT下及临床确诊的丘脑出血破入脑室病例72例,其中行神经内镜下血肿清除术患者34例(观察组),行单纯脑室外引流术的患者38例(对照组).比较两组患者治疗前后的血肿量减少情况、手术时间、术中出血量、术后引流时间以及术后3个月的GOS评分.结果 观察组与对照组比较,血肿清除更彻底,手术时间(1.65 ±0.45)h长于对照组(0.48±0.07)h,差异均有显著性意义,P ＜0.05.出血量及术后引流时间两组间差异无显著性意义,P＞0.05.术后3个月GOS评分比较,观察组优良率(61.76％)明显高于对照组(44.74％),死亡率(2.94％)明显低于对照组(10.53％),差异均有显著性意义,P＜0.05.结论 神经内镜下血肿清除术治疗丘脑出血的疗效及预后明显优于单纯脑室外引流术对丘脑出血的治疗.

Curative effect of neural endoscopic treatment of thalamic hemorrhage breaking into the ventricles

Objective To explore neural endoscopic treatment of thalamic hemorrhage (thalamus hemorrhage) in clinical effect of surgery and prognosis compared to the traditional pure ventricle drainage.Methods 72 cases of thalamic hemorrhage breaking into ventricle under the CT were selected between March 2011 and January 2014.34 cases (observation group) received neural endoscopic removal of hematoma and 38 cases underwent simple ventricular drainage (control group).The hematoma volume reduction before and after treatment,operation time,intraoperative blood loss,postoperative drainage time and postoperative GOS score in 3 month of the two groups of patients were compared.Resuits The hematoma clearance of the observation group was better than that of the control group,and there was no significant difference in the amount of bleeding and postoperative drainage time.The GOS score in the observation group was higher than that in the control group after the operation in 3 months.Conclusion Curative effect and prognosis of neural endoscopic removal of hematoma in treatment of thalamic hemorrhage is better than simple ventricular drainage treatment.