摘要
目的:探究神经内镜微创脑室血肿清除术联合脑室灌洗、外引流术对脑室出血铸型患者术后迟发性血肿发生情况及预后的影响。方法:回顾性分析2023年1—12月新余市人民医院神经外科收治的45例脑室出血铸型患者的临床资料,根据不同术式分为A组(n=20)和B组(n=25),A组行传统钻孔引流手术治疗,B组行神经内镜微创脑室血肿清除术联合脑室灌洗、外引流手术治疗。比较两组手术指标、并发症发生情况、格拉斯哥昏迷量表(GCS)评分及预后情况。结果:B组引流管留置时间、住院时间均短于A组,血肿清除率高于A组,迟发性血肿发生率低于A组(P<0.05)。B组术后再出血发生率低于A组(P<0.05),两组其他并发症发生率比较差异无统计学意义(P>0.05)。术后1 d、3 d、1周,B组GCS评分均较A组高(P<0.05)。B组预后良好率为68.00%,高于A组的35.00%(P<0.05);两组死亡率比较差异无统计学意义(P>0.05)。结论:神经内镜微创脑室血肿清除术联合脑室灌洗、外引流术可有效帮助脑室出血铸型患者清除血肿,降低术后迟发性血肿发生率及并发症发生率,缩短病程,改善预后。
Objective:To explore the effect of neuroendoscopy minimally invasive removal of ventricle hematoma combined with ventricular lavage and external drainage on the occurrence of delayed hematoma and prognosis in patients with ventricular hemorrhage casting.Method:The clinical data of 45 patients with ventricular hemorrhage casting admitted to the Department of Neurosurgery of Xinyu People's Hospital from January to December 2023 were retrospectively analyzed,and they were divided into group A(n=20)and group B(n=25)according to the operation type.Group A underwent traditional trepanation and drainage,and group B underwent neuroendoscopy minimally invasive removal of ventricle hematoma combined with ventricle lavage and external drainage.The surgical indexes,complications,Glasgow coma scale(GCS)score and prognosis were compared between the two groups.Result:The retention time of drainage tube and hospital stay in group B were shorter than those in group A,the clearance rate of hematoma was higher than that in group A,and the incidence of delayed hematoma was lower than that in group A(P<0.05).The incidence of postoperative rebleeding in group B was lower than that in group A(P<0.05),and there was no significant difference in the incidence of other complications between the two groups(P>0.05).The GCS score of group B was higher than that of group A on 1 d,3 d,1 week after operation(P<0.05).The good prognosis rate of group B was 68.00%,which was higher than 35.00%of group A(P<0.05).There was no significant difference in mortality between the two groups(P>0.05).Conclusion:Neuroendoscopy minimally invasive removal of ventricle hematoma combined with ventricular lavage and external drainage can effectively help to remove hematoma in patients with ventricular hemorrhage casting,reduce the incidence of delayed hematoma and complications,shorten the course of the disease and improve the prognosis.
作者
杨幸达
段剑
钟波
邹志斌
朱红
邹国荣
罗庆勇
胡友珠
YANG Xingda;DUAN Jian;ZHONG Bo;ZOU Zhibin;ZHU Hong;ZOU Guorong;LUO Qingyong;HU Youzhu(Neurosurgery Department,Xinyu People's Hospital,Xinyu 338025,China;不详)
出处
《中国医学创新》
CAS
2024年第29期42-46,共5页
Medical Innovation of China
基金
江西省卫生健康委科技计划项目(SKJP220210002)
新余市科技计划项目(20233090811)。
关键词
脑室出血
脑室铸型
神经内镜
脑室穿刺引流
血肿清除
术后迟发性血肿
预后
Ventricular hemorrhage
Ventricle cast
Neuroendoscopy
Ventricle puncture drainage
Hematoma removal
Postoperative delayed hematoma
Prognosis
