摘要
目的 探讨神经内窥镜治疗自发性脑出血的价值。方法 应用神经内窥镜治疗自发性脑出血 4 2例(有明确高血压病史者 2 6例 )。出血部位在基底节 2 8例 ,脑叶 5例 ,丘脑 7例 ,血肿破入脑室 1 8例 ,单纯脑室出血 2例。出血量 2 0～ 1 2 0 ml,平均 5 2 .1± 3 5 .6ml。术前 GCS3～ 5分 1 8例 ,6～ 8分 8例 ,>8分 1 6例。手术时机为发病 7h以内 1 2例 ,7～ 72 h2 7例 ,超过 72 h3例。结果 根据 ADL评分标准 ,本组 级 5例 , 级 8例 , 级 1 0例 , 级 6例 , 级 4例 ,死亡 9例。除术中发生吸入性肺炎及术后切口脑脊液漏各 1例外 ,未发生其它与手术直接相关的严重并发症。结论 神经内窥镜治疗脑出血具有创伤小、血肿清除比较彻底、并能确切止血的优点 ,扩大了手术指征 。
Objective To evaluate the application of neuroendoscope in treatment of spontaneous cerebral hemorrhage.Methods 42 cases with spontaneous cerebral hemorrhage(26 patients had exact history of hypertension) were operated with neuroendoscspe in our department. The positions of hematoma were in basal ganglion (28 cases),brain globe (5 cases),thalamus thalamus(7 cases),ventricle (2 cases) and 18 cases of hematoma ruptured into the ventricule. The volume of Hematoma was from 20 ml to 120 ml, with an average value of 52 1±35 6ml. There were 18 patients with (GCS) value 3～5, 8 with 6～8,16 with >8.Twelve patients were operated in 7 hours from attack, 27 in 72 hours and 3 over 72 hours.Results According to ADL scores, 5 cases were class I, 8 were class Ⅱ,10 were classⅢ,6 were classⅣ and 4 were class Ⅴ. Nine patients died of the disease. There were no direct complications of operation except one case with inhaled pneumonia.Conclusions Hematoma can be evacuated more completely with neuroensoscope in the treatment of spontaneous cerebral hemorrhage. The operation is minimally invasive, with exact hemostasis and few complications. Therefore, these results suggest that neuroendocope can be applied to the treatment of spontaneous cerebral hemorrhage.
出处
《心脑血管病防治》
2001年第1期16-18,共3页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
