临床神经外科杂志2019，Vol.16Issue(6)：487-491,5.DOI:10.3969/j.issn.1672-7770.2019.06.006
神经内镜清除高血压基底节区脑出血手术的疗效及方法研究
Experience of endoscopic management of hypertensive basal ganglia cerebral hemorrhage( a clinical analysis of 31 cases )
摘要
Abstract
Objective To discuss the key points of neuroendoscopy in the removal of hypertensive basal ganglia cerebral hemorrhage and discuss its therapeutic effect and surgical experience.Methods The clinical data of 31 patients with hypertensive basal ganglia cerebral hemorrhage admitted by department of Neurosurgery , NanJing Drum Tower Hospital , the Affiliated Hospital of Nanjing University Medical School from June 2016 to December 2018, were analyzed retrospectively.The hematomas were removed by cortical puncture under neuroendoscopy .The surgical efficacy and postoperative complications were analyzed , and the main points of surgical techniques such as hemostasis , improvement of hematoma clearance rate and prevention of rebleeding were summarized under neuroendoscopy.Results All the patients in this group had a history of hypertension and received preoperative diagnosis of cerebral hemorrhage by CT scan .The mean preoperative hematoma volume was ( 48.81 ±9.13 ) cm3 , intraoperative blood loss was (120.12 ±21.27) cm3 , and the operative time was (83.11 ±12.56 ) min.The average hematoma clearance rate was 90.33% within 24 hours after the operation.In this group, 1 patient died of pulmonary infection after operation , 1 patient died of deep vein thrombosis.The patients were followed up for an average of more than 6 months, including 17 patients with ADL gradeⅠ, 4 patients with ADL grade Ⅱ, 5 patients with ADL grade Ⅲ, and 3 patients with ADL grade Ⅳ. Conclusions The advantages of neuroendoscopy in hypertensive basal ganglia cerebral hemorrhage include less trauma , less irritation to brain tissue and faster postoperative recovery.The efficiency of operation can be improved by reasonable preoperative evaluation and accurate intraoperative positioning.Neuroendoscopy can create better conditions for improving postoperative quality of life in patients of basal ganglia cerebral hemorrhage.关键词
神经内镜/基底节区脑出血/高血压Key words
neuroendoscopy/basal ganglia cerebral hemorrhage/hypertension分类
医药卫生引用本文复制引用
陆天宇,刘浩,陈维涛,梁维邦,倪红斌,金伟..神经内镜清除高血压基底节区脑出血手术的疗效及方法研究[J].临床神经外科杂志,2019,16(6):487-491,5.基金项目
南京市科技局基金资助项目(201803023) （201803023）
