[1]吴春富　梁建广　马思原　陆　华　何新俊　杜延平　金　东.自制鹭嘴式神经内镜鞘辅助神经内镜手术治疗高血压性脑室出血[J].中国临床神经外科杂志,2020,(07):427-429.[doi:10.13798/j.issn.1009-153X.2020.07.004]
　WU Chun-fu,LIANG Jian-guang,MA Si-yuan,et al.Endoscopic surgery assisted by self- made egret's besky neuroendoscopic sheath for hypertensive intraventricular hemorrhage[J].,2020,(07):427-429.[doi:10.13798/j.issn.1009-153X.2020.07.004]
点击复制

自制鹭嘴式神经内镜鞘辅助神经内镜手术治疗高血压性脑室出血()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年07期
页码:
427-429
栏目:
论著
出版日期:
2020-07-25

文章信息/Info

Title:
Endoscopic surgery assisted by self- made egret's besky neuroendoscopic sheath for hypertensive intraventricular hemorrhage
文章编号:
1009-153X（2020）07-0427-03
作者:
吴春富　梁建广　马思原　陆　华　何新俊　杜延平　金　东
214001 江苏无锡，南京中医药大学无锡附属医院神经外科（吴春富、梁建广、何新俊、杜延平、金　东）；214041 江苏无锡，江南大学附属医院神经外科（马思原、陆　华）
Author(s):
WU Chun-fu1;  LIANG Jian-guang1;  MA Si-yuan2;  LU Hua2;  HE Jun-fa1;  DU Yan-ping1;  JIN Dong1.
1. Department of Neurosurgery, Wuxi Chinese Medical Hospital, Wuxi 214001, China; 2. Department of Neurosurgery, The Affiliated Hospital of Jiangnan University, Wuxi 214041, China
关键词:
高血压性脑室出血; 神经内镜手术; 鹭嘴式神经内镜鞘; 脑室外引流术
Keywords:
Hypertensive ventricular hemorrhage;  Neuroendoscope;  Self- made egret's besky neuroendoscopic sheath
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2020.07.004
文献标志码:
A
摘要:
目的 探讨自制鹭嘴式神经内镜鞘辅助神经内镜手术治疗高血压性脑室出血的疗效。方法 回顾性分析2013年1月至2018年1月收治的63例高血压性脑室出血的临床资料。在鹭嘴式神经内镜鞘辅助下神经内镜手术治疗21例（内镜组），单纯脑室外引流术治疗42例（引流组）。结果 内镜组术后血肿清除<60%有1例，60%~90%有9例，>90%有11例；引流组术后血肿清除<60%有40例，60%~90%有1例，>90%有1例；内镜组血肿清除率明显优于引流组（P<0.01）。内镜组术后并发症发生率（4.76%，1/21）明显低于引流组（30.96%，13/42；P<0.05)。术后 6个月，内镜组预后良好率（85.71%，18/21；ADL分级Ⅰ~Ⅲ级）明显高于引流组（52.38%，22/2；P<0.05）。结论 对于高血压性脑室出血，自制鹭嘴式神经内镜鞘能扩大操作空间，可提高神经内镜手术血肿清除率，减少并发症，明显改善病人预后
Abstract:
Objective To explore the clinical effect of endoscopic surgery assisted by self- made egret's besky neuroendoscopic sheath on hypertensive ventricular hemorrhage (HVH). Methods The clinical data of 63 patients with HVH who were admitted to our hospital from January 2013 to January 2018 were retrospectively analyzed. Of these 63 patients, 21 patients were treated with endoscopic surgery assisted by self- made egret's besky neuroendoscopic sheath (endoscopy group), and 42 were treated with extraventricular drainage (drainage group). Results The postoperative hematoma clearance rates <60%, 60%~90%, and >90% were achieved in 1, 9, and 11 patients in the endoscopy group, and in 40, 1 and 1 patients in the drainage group, respectively. The hematoma clearance rate in the endoscopic group was significantly better than that in the drainage group (P<0.01). The incidence of postoperative complications in the endoscopic group (4.76%, 1/21) was significantly lower than that in the drainage group (30.96%, 13/42; P<0.05). Six months after surgery, the good rate of prognosis in the endoscopic group (85.71%, 18/21; ADL grades Ⅰ~Ⅲ) was significantly higher than that in the drainage group (52.38%, 22/42; P<0.05). Conclusions For HVH, self- made egret's besky neuroendoscopic sheath can expand the operation space in order to improve the clearance rate of hematoma during neuroendoscopic surgery, reduce the complications and significantly improve the prognosis of patients

参考文献/References:

[1] Basaldella L, Marton E, Fiorindi A, et al. External ventricu- lar drainage alone versus endoscopic surgery for severe intraventricular hemorrhage: a comparative retrospective analysis on outcome and shunt dependency [J]. Neurosurg Focus, 2012, 32(4): 4-11.
[2] Rui G, Lu M, Bal KS, et al. a retrospective clinical study of 98 adult idiopathic primary intraventricular hemorrhage cases [J]. Medicine, 2016, 95: 42.
[3] 张亚卓. 质量是神经内镜技术发展的保证[J]. 中华神经外 科杂志，2007，23（3）：161-162.
[4] 唐元辉，马建荣，周　杰，等. 神经内镜治疗自发性脑室出 血的疗效分析[J]. 国际神经病学神经外科学杂志，2014， 41（3）：205-208.
[5] 熊云彪，杨承勇，黄生炫，等. 支撑通道辅助神经内镜对高 血压脑室出血患者的疗效[J]. 中华医学杂志，2012，92 （19）：1337-1339.
[6] 童民锋，刘继红，章　威，等. 内镜下经皮质加透明隔造瘘 治疗脑室出血的疗效分析[J]. 中华全科医学，2016，14 （3）：362-364.
[7] 李育平，张恒柱，杜任飞. 神经内镜对比传统脑室外引流 治疗脑室出血的Meta分析[J]. 中国神经精神疾病杂志， 2013，39（3）：135-145.
[8] 阮　航，段发亮，罗　明，等. 神经导航下内镜手术与脑室 外引流术治疗脑室出血的比较[J]. 中国临床神经外科杂 志，2019，24（5）：299-300.
[9] 易明琪，张志钢. 神经内镜手术治疗高血压脑出血[J]. 中 国内镜杂志，2011，17（8）：856-858.
[10] 吴春富，陆　华，朱爱华，等. 自制神经内镜辅助器械治疗 高血压性脑室出血[J]. 中华神经医学杂志，2011，10（3）： 308-310.
[11] Nakano T, Ohkuma H, Ebina K, et al. Neuroendoscopic sur- gery for intracerebral haemorrhage-comparison with tradi- tional therapies [J]. Minim Invas Neurosurg, 2003, 46(5)： 278-283.
[12] Waran V, Vairavan N, Sia SF, et al. A new expandable can- nula system for endoscopic evacuation of intraparenchymal hemorhages [J]. J Neurosurg, 2009, 111(6): 1127-1130.

相似文献/References:

[1]张文华　谢　蒙　王　旋　林敏华.内镜手术与显微手术治疗垂体瘤疗效的Meta分析[J].中国临床神经外科杂志,2015,(02):78.[doi:10.13798/j.issn.1009-153X.2015.02.004]
　ZHANG Wen-hua,XIE Meng,WANG Xuan,et al.Endoscopic surgery and microsurgery for pituitary adenomas: a Meta analysis[J].,2015,(07):78.[doi:10.13798/j.issn.1009-153X.2015.02.004]
[2]赵建平,张红波,穆林森,等.内镜下经鼻蝶术后迟发性鼻出血的护理[J].中国临床神经外科杂志,2016,(12):794.[doi:10.13798/j.issn.1009-153X.2016.12.025]
[3]丁伟龙　王向宇　王晓东.神经内镜手术和显微手术治疗幕上高血压性脑出血疗效的Meta分析[J].中国临床神经外科杂志,2018,(07):463.[doi:10.13798/j.issn.1009-153X.2018.07.005]
　DING Wei-long,WANG Xiang-yu,WANG Xiao-dong..Comparison of endoscopic surgery and craniotomy for supratentorial hypertensive intracerebral hemorrhage: a meta-analysis[J].,2018,(07):463.[doi:10.13798/j.issn.1009-153X.2018.07.005]
[4]李茂雷　栾　雷　李录华　刘　阳　丰育功.显微镜下和神经内镜下手术治疗高血压性基底节区出血[J].中国临床神经外科杂志,2019,(03):171.[doi:10.13798/j.issn.1009-153X.2019.03.016]
[5]钟　琪　何　林　刘　平　郑燎原.神经内镜手术治疗高血压性脑出血的疗效分析[J].中国临床神经外科杂志,2020,(02):91.[doi:10.13798/j.issn.1009-153X.2020.02.010]
　ZHONG Qi,HE Lin,LIU Ping,et al.Effect of neuroendoscopic surgery on hypertensive cerebral hemorrhage[J].,2020,(07):91.[doi:10.13798/j.issn.1009-153X.2020.02.010]
[6]谢燕梅　陈伟明　陈才奋.非功能性垂体腺瘤神经内镜下经蝶入路术后迟发性低钠血症的影响因素[J].中国临床神经外科杂志,2020,(06):388.[doi:10.13798/j.issn.1009-153X.2020.06.016]
[7]王凤伟　杨金庆　薛　勇.3D-Slicer软件辅助神经内镜手术治疗高血压性基底节区出血[J].中国临床神经外科杂志,2020,(07):470.[doi:10.13798/j.issn.1009-153X.2020.07.018]
[8]王学建　蒋晓明.神经内镜手术治疗慢性硬膜下血肿锥颅术后短期复发1例[J].中国临床神经外科杂志,2020,(11):813.[doi:doi:10.13798/j.issn.1009-153X.2020.11.030]
[9]周朝阳　朱荣岚　姜星星等.神经内镜手术联合脑室外引流术与单纯脑室外引流术治疗脑室出血的疗效比较[J].中国临床神经外科杂志,2021,26(02):77.[doi:10.13798/j.issn.1009-153X.2021.02.004]
　ZHOU Chao-yang,ZHU Rong-lan,JIANG Xing-xing,et al.Comparison of curative effect on intraventricular hemo-rrhage: neuroendoscopic surgery combined with extra-ventricular drainage vresus simple extraventricular drainage[J].,2021,26(07):77.[doi:10.13798/j.issn.1009-153X.2021.02.004]
[10]王建飞　石东付　卢国奇等.经鼻蝶入路神经内镜手术和显微手术治疗垂体腺瘤的疗效[J].中国临床神经外科杂志,2021,26(02):117.[doi:10.13798/j.issn.1009-153X.2021.02.017]

备注/Memo

备注/Memo:
（2019-06-30收稿，2019-11-10修回）基金项目：无锡市科技发展医疗卫生指导性项目（2014CSZON1416）
更新日期/Last Update: 2020-07-20