神经内镜联合脑室外引流及腰大池引流序贯治疗中重度脑室出血临床研究

发布时间：2018-04-30 14:34

本文选题：脑室出血 + 神经内镜　；参考：《南昌大学》2017年硕士论文

【摘要】：目的:比较神经内镜下清除血肿联合脑室外及腰大池引流序贯治疗与单纯脑室外引流治疗中重度脑室出血的临床疗效。方法:回顾性分析南昌大学第二附属医院神经外科2014年9月~2016年7月脑室出血96例患者,筛选出中重型脑室出血48例患者,内镜治疗组25例和单纯引流组23例,分别予以神经内镜下清除血肿联合脑室外及腰大池引流序贯治疗和单纯脑室外引流治疗,比较两组的血肿清除率,术后脑室引流管拔除时间,术后颅内感染率,术后交通性脑积水发生率以及治疗效果。结果:内镜治疗组术中血肿清除率显著优于单纯引流组(69.33%±6.09 VS12.67%±5.12),差异有统计学意义(P0.05)。内镜治疗组的脑室引流管拔除时间显著短于单纯引流组(7.1±0.81 VS 13.1±1.26),差异有统计学意义(P0.05)。内镜治疗组颅内感染(4%VS 11.7%)及脑积水(4%VS 13.3%)发生率显著低于单纯引流组。内镜治疗组的恢复良好率显著高于单纯引流组(76%VS52%),差异有统计学意义(P0.05)。结论:神经内镜下清除血肿联合脑室外引流及腰大池引流序贯治疗中重度脑室出血可以显著改善患者的预后及减少相关并发症发生率,安全可靠,值得临床推广应用。
[Abstract]:Objective: to compare the clinical effects of neuroendoscopic hematoma removal combined with ventricular drainage and lumbar cistern drainage in the treatment of moderate and severe ventricular hemorrhage. Methods: 96 patients with ventricular hemorrhage from September 2014 to July 2016 in Neurosurgery Department, second affiliated Hospital of Nanchang University were retrospectively analyzed. Forty-eight patients with moderate and severe ventricular hemorrhage were selected, 25 patients in endoscopic treatment group and 23 in simple drainage group. The hematomas were removed by endoscopy combined with sequential treatment of ventricular drainage and lumbar cistern drainage, respectively. The hematoma clearance rate, the time of extubation of ventricular drainage tube, and the postoperative intracranial infection rate were compared between the two groups. Postoperative incidence and treatment of communicating hydrocephalus. Results: the operative hematoma clearance rate in the endoscopic treatment group was significantly higher than that in the simple drainage group (69.33% 卤6.09 vs 12.67% 卤5.12), and the difference was statistically significant (P 0.05). The extubation time of ventricular drainage tube in the endoscopic treatment group was significantly shorter than that in the simple drainage group (7.1 卤0.81 vs 13.1 卤1.26), and the difference was statistically significant (P 0.05). The incidence of intracranial infection and hydrocephalus in endoscopic treatment group was significantly lower than that in simple drainage group. The recovery rate of endoscopic treatment group was significantly higher than that of simple drainage group (P 0.05). Conclusion: neuroendoscopic hematoma removal combined with ventricular drainage and lumbar cistern drainage can significantly improve the prognosis and reduce the incidence of related complications in patients with moderate and severe ventricular hemorrhage. It is safe and reliable and worthy of clinical application.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.1

【参考文献】