应用神经内镜治疗外伤性脑内血肿的经验
徐 纲 李雪松 荆国杰 【摘要】 目的 探讨应用神经内镜治疗外伤性脑内血肿的方法。 方法 对31例外伤性脑内血肿应用神经内镜手术治疗。 结果 手术时间50～100min，平均72min，31例中血肿清除80%以上者22例，80%以下者9例。术后残留血肿超过10ml者10例，应用尿激酶溶解血肿获得满意效果。根据ADL评分标准，Ⅰ级:15例，Ⅱ级:10例，Ⅲ级:6例。无术后再出血、死亡、感染病例。 结论 应用神经内镜清除血肿具有直视下操作、手术创伤小、手术时间短、血肿清除率高和术后疗效好的优点，但有视野小，操作空间有限的局限性，故术前应充分估计。术后应用尿激酶灌注有助于巩固术后疗效。 【关键词】 外伤性脑内血肿 神经内镜 微侵袭术 尿激酶
The application experience of neuroendoscopy for traumatic intracerebral hematoma treatment
Xu Gang，Li Xuesong，Jing Guojie
Department of Neurosurgery，Central People s Hospital of Huizhou City，Guangdong Province516001.
【Abstract】 Objective To investigate the treatment of traumatic intracranial hematoma with neuroendoscopy.Methods 31cases were studied with applying neuroendoscopy.Results The operation lasted for50～110minutes in different cases，72minutes on average.Above80%hematoma were removed in22cases while in the other9cases，the hematoma were removed under80%.In10cases the remained hematoma excess10ml.Satisfactory results were achieved by applying urokinase to dissolve the hematoma.According to the ADL criteria，first degree:15cases，second degree:10cases，third degree:6cases among the31cases.No hemorrhage，death or infection cases occurred after the operations.Conclusion Applying neuroendoscopes to clear the intracranial hematoma，there are some advantages such as performing under direct vision，minimal damage，short duration of operation，the high cleaning rate of the hematoma，the better postoperation results.However there are some limits of it，the small field of vision and the limited space for operating.So thoroughly estimaton should be done before operations.Infusion with urokinase after the operations will benefit the clinical results.
【Key words】 traumatic intracranial hematoma neuroendoscopy micro
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