發(fā)布時(shí)間：2018-04-30 14:34

  本文選題：腦室出血 + 神經(jīng)內(nèi)鏡��； 參考：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:比較神經(jīng)內(nèi)鏡下清除血腫聯(lián)合腦室外及腰大池引流序貫治療與單純腦室外引流治療中重度腦室出血的臨床療效。方法:回顧性分析南昌大學(xué)第二附屬醫(yī)院神經(jīng)外科2014年9月~2016年7月腦室出血96例患者,篩選出中重型腦室出血48例患者,內(nèi)鏡治療組25例和單純引流組23例,分別予以神經(jīng)內(nèi)鏡下清除血腫聯(lián)合腦室外及腰大池引流序貫治療和單純腦室外引流治療,比較兩組的血腫清除率,術(shù)后腦室引流管拔除時(shí)間,術(shù)后顱內(nèi)感染率,術(shù)后交通性腦積水發(fā)生率以及治療效果。結(jié)果:內(nèi)鏡治療組術(shù)中血腫清除率顯著優(yōu)于單純引流組(69.33%±6.09 VS12.67%±5.12),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。內(nèi)鏡治療組的腦室引流管拔除時(shí)間顯著短于單純引流組(7.1±0.81 VS 13.1±1.26),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。內(nèi)鏡治療組顱內(nèi)感染(4%VS 11.7%)及腦積水(4%VS 13.3%)發(fā)生率顯著低于單純引流組。內(nèi)鏡治療組的恢復(fù)良好率顯著高于單純引流組(76%VS52%),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:神經(jīng)內(nèi)鏡下清除血腫聯(lián)合腦室外引流及腰大池引流序貫治療中重度腦室出血可以顯著改善患者的預(yù)后及減少相關(guān)并發(fā)癥發(fā)生率,安全可靠,值得臨床推廣應(yīng)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% 鹵6.09 vs 12.67% 鹵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 鹵0.81 vs 13.1 鹵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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R651.1

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本文編號(hào)：1824942