摘要
目的应用神经内镜采取经皮质加透明隔造瘘的方法治疗脑室出血,同时与常规脑室外引流治疗脑室出血做对比,观察两种方法的临床疗效。方法将浙江大学金华医院2012年6月—2014年6月,符合自发性脑室出血诊断标准的112例患者随机分为治疗组和对照组,治疗组57例采用内镜下经皮质加透明隔造瘘术治疗,对照组55例采用脑室外引流术治疗。主要观察2组患者的手术时间、术后3 d CT血肿清除情况、置管时间、术后并发症（继发性出血、颅内感染、脑积水）、病程及3个月后格拉斯哥预后评分（GOS）等临床疗效性指标。采用SPSS13.0统计软件对上述疗效指标进行统计分析。组间对比运用t检验,计数资料采用χ^2检验,等级资料采用秩和检验。通过统计分析比较2组患者的预后。结果术后3 d CT显示,治疗组50例（87.72%）患者血肿清除率≥50%,对照组18例（32.73%）患者血肿清除率≥50%,2组差异有统计学意义（Z=6.2002,P〈0.01）。同时治疗组在术后并发症、置管时间、病程、病死率、术后3个月格拉斯哥预后评分等方面均优于对照组（统计值分别为χ^2=4.193,χ^2=11.009,χ^2=9.843,t=14.096,t=14.629,Z=3.239,P〈0.05）。而2组间手术时间差异无统计学意义（P〉0.05）。结论神经内镜下经皮质加透明隔造瘘清除脑室出血,血肿清除率高,可明显降低自发性脑室出血患者的致残率和病死率,减少并发症,缩短病程,减轻患者家庭经济负担。
Objective To compare the clinical efficacy of neuroendoscopic transcortical fenestration of septum pellucidum and conventional ventricular drainage in treatment of intraventricular hemorrhage. Methods Total 112 patients with spontaneous intraventricular hemorrhage in our hospital from Jun. 2012 to Jun. 2014 were randomly divided into observation group（ 57 cases） and control group（ 55 cases）. The observation group received neuroendoscopic transcortical fenestration of septum pellucidum,while control group received external ventricle drainage. The time of operation,removal of hematoma,indwelling time,postoperative complications（ secondary hemorrhage,intracranial infection,hydrocephalus）,disease duration,mortality,Glasgow prognostic score GOS） 3 months later,and other clinical curative effect index were observed.The statistical analysis was carried out by SPSS 13. 0 software,The quantitative data was described with mean and standard deviation（ s）,Student t-test for the quantitative variables and Chi-square test for the categorical variables,and Wilcoxon signed-rank test for rank data were performed. The prognosis of the two groups was compared by statistical analysis.Results 3 days after the operation,CT showed that the hematoma clearance rate was greater than 50% in the 50 cases（ 87. 72%） of the treatment group and 18 cases（ 32. 73%） in the control group. Statistical analysis： Z = 6. 2002,P〈0. 01,there were significant differences. At the same time,the postoperative complications,the time of catheterization,the course of disease,the mortality,and the prognosis of the Glasgow（ GOS） 3 month after the operation were better than that in the control group（ χ^2= 4. 193,χ^2= 11. 009,χ^2= 9. 843,t = 14. 096,t = 14. 629,Z = 3. 239,P〈0. 05）. The operation time between the two groups had no statistically significance（ P〉0. 05）. Conclusion The removal of ventricular hemorrhage with neuroendoscopic transcortical fenestration of septum pellucidum has higher hematoma clearance rate
出处
《中华全科医学》
2016年第3期362-364,共3页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2013C33103)
关键词
神经内镜
脑室出血
脑室外引流
并发症
Neuroendoscopy
Intraventricular hemorrhage
External ventricle drainage
Complications
