神经内镜辅助小骨窗开颅术治疗高血压脑出血56例疗效分析

目的：探讨神经内镜辅助小骨窗开颅手术治疗高血压脑出血的效果。方法：56例高血压脑出血患者均在全麻下行神经内镜辅助小骨窗开颅术。结果：32例血肿基本清除，20例血肿残留量小于10％，无一例再出血，10例单侧瞳孔散大者均回缩。4例出院后死亡，存活52例。根据ADL（日常生活能力）分级：1级10例、2级22例、3级10例、4级8例、5级2例。结论：该术式损伤小，进入病灶时间短，血肿清除及止血彻底。但操作空间狭小，对设备及手术医师显微技术要求高，且对血肿量较大的患者无“外减压”效果，不利于在基层推广使用。

Endoscope-assisted small bone window craniotomy for hypertensive cerebral hemorrhage: clinical analysis of 56 cases

Objective:To investigate the effects of endoscope-assisted small bone window craniotomy on hypertensive cerebral hemorrhage.Methods:Endoscope-assisted small bone window craniotomy was performed on 56 patients with hypertensive cerebral hemorrhage under general anesthesia.Results:Complete hematoma clearance were observed in 32 cases,less than 10% residual hematoma volume in 20 cases,no re-bleeding occurred.10 cases of unilateral mydriasis regained normal size.4 patients died after discharge,and 52 survived.According to Activity of Daily Living Scale(ADL),10 cases were evaluated as grade 1,22 cases grade 2,10 cases grade 3,8 cases grade 4,and 2 cases level 5.Conclusion:With advantages of smaller lesion,quicker access of focus,complete clearance of hematoma and hemostasia,and disadvantages of small operating space,high requirements for micro-surgeon equipments and operative technique,no decompression effects on patients with large amount of hematoma,endoscope-assisted small bone window craniotomy is not good for application in primary hospitals.