关键词: 神经内镜手术, 血肿清除, 侧脑室外引流术, 脑室出血铸型

Abstract: Objective To investigate the clinical effect of neuroendoscope guided hematoma evacuation in the treatment of severe intraventricular hemorrhage cast. Methods 40 patients with severe intraventricular hemorrhage and casting treated in the Department of Neurosurgery of the First Affiliated Hospital of Xinxiang Medical College from December 2018 to June 2021,20 in the control group and 20 in the endoscopy group were retrospectively analyzed.The hematoma clearance of each group was compared and evaluated according to the preoperative and postoperative MGS scores.The dosage of urokinase,the indwelling time of drainage tube,and the incidence of complications such as rebleeding,hydrocephalus and intracranial infection were compared and evaluated.The prognosis was evaluated 3 months after operation.ADL grade Ⅰ - Ⅲ was effective.Results In the endoscopic group,the preoperative MGS score was 24.55±3.00 and the postoperative MGS score was 14.45±4.72.In the control group,the preoperative MGS score was 24.70±3.71 and the postoperative MGS score was 20.40±3.70.The data compared within groups before and after operation was statistically significant( P<0.05).The preoperative MGS score between the two groups was no significant difference.(P>0.05),the postoperative MGS score btween the two groups were statistically significant( P<0.05),and the amount of residual hematoma in the endoscopic group was less.The dosage of urokinase was (3.65±3.24)million U in the endoscopic group and (10.15±3.26)million U in the control group.The retention time of extraventricular drainage was (8.3±1.7)days in the endoscopic group and (11.6±1.7)days in the control group.The incidence of postoperative complications was 10.0% in the endoscopic group and 35.0% in the control group.Three months after operation,the effective rate of ADL score in endoscopic group was 70.0%(14 / 20).The effective rate of the control group was 30.0%(6/20),and the prognosis of the endoscopic group was better.Conclusion Neuroendoscopic hematoma removal in the treatment of severe intraventricular hemorrhage casting can quickly reduce the volume of hematoma,alleviate acute obstructive hydrocephalus,reduce complications and improve prognosis.It is safe and effective.

Key words: neuroendoscopic surgery, hematoma clearance, lateral ventricle drainage, intraventricular hemorrhage cast