急诊科开展神经内镜治疗高血压脑出血的临床研究

目的探讨急诊科开展神经内镜手术治疗高血压脑出血的临床价值。方法1999年7月至2003年12月我院急诊科开展神经内镜手术治疗自发性脑出血101例。对其时效性、疗效、并发症等方面进行分析。结果从入院到手术间隔时间为(68.6±38.3)min。出血部位在基底节51例,脑叶27例,丘脑9例,血肿破入脑室14例。出血量20~130ml,平均(53.3±36.8)ml。手术时机为发病7h以内36例,7~72h43例,超过72h22例。手术时机越早,其疗效越好,并发症越少(P<0.001)。同时血肿量越大,疗效越差(P<0.001)。结论急诊科应用神经内镜治疗高血压脑出血具时效性、整体性和微创性统一,扩大了手术指征,值得进一步研究和推广应用。

Value of neuroendoscope in the treatment of hypertensive cerebral hemorrhage in the emergency department

ObjectiveTo study the application of neuroendoscope in the treatment of hypertensive cerebral hemorrhage in emergency department. MethodsFrom July 1999 to December 2003,101 patients with spontaneous cerebral hemorrhage were operated using neuroendoscope in our department. We retrospectively analyzed the therapeutic efficacy,time-effect and complications between the three groups according to different onset-operation intervals. ResultsInterval between admission and operation was (68.638.3)min. The positions of hematoma were in basal ganglion (51cases), brain globe (27cases), thalamus (9cases), and hematoma ruprured into the ventricule (14cases). The volume of hematoma was from 20 ml to 120 ml,with an average value of (53.336.8) ml. 36 Patients were operated in 7 hours from onset, 43 cases in 72 hours and 22 cases over 72 hours. The earlier the patients were operated, the better functional recovery and fewer complications were achieved. In additional, the progress was negatively related to the volume of hematoma. ConclusionThe application of nersoendoscope in the treatment of hypertensive cerebral hemorrhage in emergency department has the unifying effect of time-effect,holism and minimal invasion and deserves advanced study.