脑室出血微创治疗中的临床对比研究

目的：探讨微创治疗脑室出血的新方法.方法：应用神经内镜微创治疗脑室出血患者22例为内镜组;以传统的单纯脑室体外引流术治疗同类患者20例为对照组,并进行比较评分.结果：内镜组术后24 h复查头颅CT,脑内或（和）脑室内血肿清除90%以上15例,而脑室引流组,仅有3例清除60%以下,均无继发出血;内镜组中无颅内感染,脑室引流组有2例;术后2个月格拉斯哥结果分级评分（GOS）,内镜组和脑室引流组中分别为：5分各5例、1例;4分各9例、5例；3分各4例、7例;2分各2例、5例;1分各2例.脑室引流组与内镜组比较,术后好转优良率低（χ2=4.752,P＜0.05）,差异有统计学意义,死亡率差异无统计学意义（χ2=0.010,P＞0.05）.结论：应用神经内镜清除脑室内血肿,具有直视下操作、术后疗效好等优点,是外科治疗脑室出血较佳的方法.

Comparative study of minimally invasive treatment in intraventricular hemorrhage

Objective:To evaluate the effect of minimally invasive treatment in intraventricular hemorrhage.Methods:Neuroendoscopy was applied in 22 cases of ventricular hemorrhage.Ventricular drainage was used for 20 cases as a control.Results:All were followed up for 2 months.In neuroendoscope group,nearly complete evacuation of intracerebral or /and intraventricular hematoma was achieved in 15 cases;no intracranial infection after surgery and secondary hemorrhage happened according to Glasgow outcome scale(GOS),the result was excellent in 5 cases,good in 9 cases,fare in 4 cases,poor in 2 cases,dead in 2 cases.In ventricular drainage group,partial evacuation of intracerebral or /and intraventricular hematoma was achieved in 3 cases;intracranial infection after surgery happened in 2 cases;no secondary hemorrhage was founed;according to GOS,the result was excellent in 1 case,good in 5 cases,fare in 7 cases,poor in 5 cases,dead in 2 cases.More patients in the neuroendoscope group showed good recovery after two months(P<0.05).The difference between two groups in mortality was not statistically significant(P>0.05).Conclusion:Neuroendoscopic surgery for ventricular hemorrhage is a better surgical treatment because of its visualized manipulation,minimum invasion,effective hemorrhage evacuation and excellent postoperative outcome.