摘要
目的探讨微创开颅四脑室血肿清除联合脑室外引流治疗重型脑室出血的临床疗效。方法筛选2016-01—2018-01新乡市中心医院收治的58例自发性重型脑室出血患者,随机分为开颅组(行微创开颅四脑室血肿清除联合脑室外引流术)和对照组(单纯行双侧脑室外引流术)各29例。比较2组患者术前与术后24 h GCS评分、术后3 d脑室内血肿清除率、脑室引流管带管时间、术后并发症(再出血、颅内感染、脑积水)发生率、术后6个月存活患者日常生活能力(ADL)评分。结果开颅组患者术前与术后24 h GCS评分比较,差异有统计学意义(P<0.05);开颅组术后3 d脑室内血肿清除率、脑室引流管带管时间、术后并发症发生率及术后6个月存活患者ADL评分与对照组比较,差异均有统计学意义(P<0.05),开颅组治疗效果优于对照组。结论采用微创开颅四脑室血肿清除联合脑室外引流术治疗重型脑室出血,能明显改善患者预后。
Objective To investigate the clinical effect of minimally invasive craniotomy for the removal of hematoma in the fourth ventricle combined with external ventricular drainage(EVD)in the treatment of severe intraventricular hemorrhage(sIVH).Methods 58 patients with spontaneous sIVH admitted to our department from January 2016 to January 2018 were selected and randomly divided into craniotomy group(Minimally invasive craniotomy for the removal of hematoma in the fourth ventricle combined with EVD)and control group(bilateral EVD only)with 29 cases in each group.The GCS score before operation and 24 hours after operation,the clearance rate of intraventricular hematoma 3 days after operation,the time of ventricular drainage tube.The incidence of postoperative complications(rebleeding,intracranial infection,hydrocephalus),and the activities of daily living(ADL)score of patients surviving 6 months after operation were compared between the two groups.Results There was a significant difference between preoperative GCS score and postoperative GCS score of 24 hours in craniotomy group(P<0.05),while there was no difference in control group(P>0.05).Compared with the control group,the clearance rate of intraventricular hematoma 3 days after operation,the time of ventricular drainage tube,the incidence rate of postoperative complications and the ADL score of patients surviving 6 months after operation in the craniotomy group have statistically significant differences(P<0.05).The therapeutic effect of the craniotomy group is better than that of the control group.Conclusion This study shows that for sIVH,minimally invasive craniotomy for the removal of hematoma in the fourth ventricle combined with EVD can significantly improve the prognosis of patients and is worthy of clinical promotion.
作者
路贵
杜宝顺
王阳
程振国
LU Gui;DU Baoshu;WANGY Yang;CHENG Zhenguo(Department of Neurosurgery,Xinxiang Central Hospital,Xinxiang 453000,China)
出处
《中国实用神经疾病杂志》
2020年第1期60-65,共6页
Chinese Journal of Practical Nervous Diseases
关键词
重症脑室出血
四脑室血肿清除
脑室外引流术
微创
预后
Severe intraventricular hemorrhage
Removal of hematoma in fourth ventricle
Extraventricular drainage
Minimally invasive
Prognosis
作者简介
路贵,Email:ylugui824@123.com。
