[1]殷志林　樊晶鑫　谭一虎　卢俊章　胡腾华　王少兵　陈　坚.球囊脑造通辅助显微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,2021,26(07):521-523.[doi:10.13798/j.issn.1009-153X.2021.07.008]
　YIN Zhi-lin,FAN Jin-xin,TAN Yi-hu,et al.Microsurgery through cerebral corridor created by sacculus for patients with hypertensive cerebral hemorrhage[J].,2021,26(07):521-523.[doi:10.13798/j.issn.1009-153X.2021.07.008]
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球囊脑造通辅助显微手术治疗高血压性脑出血的疗效分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年07期
页码:
521-523
栏目:
论著
出版日期:
2021-07-25

文章信息/Info

Title:
Microsurgery through cerebral corridor created by sacculus for patients with hypertensive cerebral hemorrhage
文章编号:
1009-153X（2021）07-0521-03
作者:
殷志林　樊晶鑫　谭一虎　卢俊章　胡腾华　王少兵　陈　坚
Author(s):
YIN Zhi-lin1;  FAN Jin-xin1;  TAN Yi-hu1;  LU Jun-zhang1;  HU Teng-hua1;  WANG Shao-bing1;  CHEN Jian2.
1. Department of Neurosurgery, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan 430015, China; 2. Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030,
关键词:
高血压性脑出血; 球囊脑造通; 显微手术; 疗效
Keywords:
Hypertensive cerebral hemorrhage;  Microsurgery;  Cerebral corridor creator;  Sacculus;  Clinical efficacy
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2021.07.008
文献标志码:
A
摘要:
目的 探讨球囊脑造通辅助显微手术治疗高血压性脑出血的效果。方法 回顾性分析2018年9月~2020年6月应用球囊脑造通辅助显微手术治疗的58例高血压性脑出血的临床资料。术后24 h复查头部CT，计算血肿清除率；术后随访6个月，采用GOS评分评价预后，4~5分为预后良好。结果 术后24 h复查头部CT，血肿清除率>90%有40例，80%~90%有15例，60%~80%有3例；平均血肿清除率为（91.8±6.7）%。术后无死亡、颅内感染、脑积水并发症，术后出现再出血2例、肺部感染7例、硬脑膜下积液3例；并发症总发生率为21.4%（12/56）。术后56例随访6个月，恢复良好14例 ，中残23例，重残13例，植物生存6例；预后良好率为66.1%（37/56）。结论 球囊脑造通辅助显微手术治疗高血压性脑出血创伤小，效果良好。
Abstract:
Objective To investigate the clinical efficacy of microsurgery through cerebral corridor created by sacculus for the patients with hypertensive cerebral hemorrhage (HCH). Methods The clinical data of 58 patients with HCH who underwent microsurgery through cerebral corridor created by sacculus from September 2018 to June 2020 were analyzed retrospectively. Results Hematoma clearance rate >90% was achieved in 40 patients, 80%~90% in 15 and 60%~80% in 3 according to the 24-hour postoperative CT images. The average clearance rate was (91.8±6.7)%. Six-month follow up was performed on 56 patients of whom 14 patients had GOS scors of 5, 23 had GOS score of 4, 13 patients had GOS score of 3, and 6 patients had GOS score of 2. The rate of good prognosis (GOS score of 4~5) was 66.1%(37/56). There was no death, intracranial infection and hydrocephalus. The total incidence of postoperative complications was 21.4% (12/58), including 2 pateints with rebleeding, 7 patients with pulmonary infection and 3 patients with subdural effusion. Conclusions Microsurgery through cerebral corridor created by sacculus, which has the advantages of small trauma and good clinical effcacy, is a good treatment method for the patients with HCH.

参考文献/References:

[1] Hostettler IC, Seiffge DJ, Werring DJ. Intracerebral hemo-rrhage: an update on diagnosis and treatment [J]. Expert RevNeurother, 2019, 19(7): 679-694.
[2] Vespa P, Hanley D, Betz J, et al. ICES (intraoperative stere-otactic computed tomography-guided endoscopic surgery) for brain hemorrhage: a multicenter randomized controlled trial [J]. Stroke, 2016, 47(11): 2749-2755.
[3] Sun G, Li X, Chen X, et al. Comparison of keyhole endosco-py and craniotomy for the treatment of patients with hyper-tensive cerebral hemorrhage [J]. Medicine (Baltimore), 2019, 98(2): e14123.
[4] 范学政，黄进能，朱寿鸿，等. 神经内镜和显微手术治疗脑出血的疗效及卫生经济学比较[J]. 实用医学杂志，2016，32（18）：3007-3010.
[5] 尹乾坤. 高血压脑出血手术治疗近期预后的影响因素[J].中国实用神经疾病杂志，2016，19（16）：82-83.
[6] Feng Y, He JQ, Liu B, et al. Endoscope-assisted keyhole technique for hypertensive cerebral hemorrhage in elderly patients: a randomized controlled study in 184 patients [J]. Turk Neurosurg, 2016, 26(1): 84-89.
[7] Xu XH, Zheng Y, Chen XL, et al. Comparison of endoscopic evacuation, stereotactic aspiration and craniotomy for the treatment of supratentorial hypertensive intracerebral haemorrhage: study protocol for a randomised controlled trial [J]. Trials, 2017, 18(1): 296.
[8] Gregson BA, Broderick JP, Auer LM, et al. Individual patient datd subgroup meta-analysis of surgery for sponta-neous supratentorial intracerebral hemorrhage [J]. Stroke, 2012, 43(6): 1496-1504.
[9] 胡永珍，文世宏，张立阳，等. 微球囊辅助脑造通器在神经内镜下手术治疗基底节区脑出血中的应用[J]. 中国内镜杂志，2019，25（10）：56-63.
[10] 刘宏斌，周厚杰，郭　强，等. 神经内镜辅助下小骨窗手术治疗高血压性脑出血体会[J]. 中国临床神经外科杂志，2020，25（1）：48-50.
[11] 钟　琪，何　林，刘　平，等. 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，2020，25（2）：91-93.
[12] 潘仁高. 脑内镜联合脑造通器在高血压脑出血手术中的价值分析[J]. 中国现代药物应用，2015，9（15）：3-5.

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备注/Memo

备注/Memo:
基金项目：430015 武汉，湖北省中西医结合医院神经外科（殷志林、樊晶鑫、谭一虎、卢俊章、胡腾华、王少兵)；430030 武汉，华中科技大学同济医学院附属同济医院神经外科（陈　坚）
通讯作者：陈　坚，E-mail：husttjchen110@163.com
更新日期/Last Update: 2021-07-25