【摘要】
? 目的 研制一種高血壓腦出血手術(shù)專用擴(kuò)張通道,，以減少手術(shù)時(shí)過度牽拉腦組織，造成不必要的醫(yī)源性損傷,，減輕繼發(fā)性神經(jīng)功能損害,。
? 方法 將兩個(gè)大小不一的透明擴(kuò)張通道相互套疊，前端縮小成錐形,。使用時(shí)從腦組織皮層造瘺口進(jìn)入,，當(dāng)看到內(nèi)套管尖端發(fā)黑時(shí)，表示已進(jìn)入血腫腔,，拔除內(nèi)套管,，顯微鏡輔助下在外套管內(nèi)進(jìn)行手術(shù)操作。
? 結(jié)果 本組患者手術(shù)平均時(shí)間（95.21±15.12）min,，血腫清除率(98.24±2.31)%,，住院時(shí)間(20.15±5.04)d，GOS預(yù)后評(píng)分(4.64±1.42),，患者生存率升高,，生存質(zhì)量提高，取得明顯效果,。
? 結(jié)論 該手術(shù)專用擴(kuò)張通道具有：輕巧，直觀,，損傷小,，減少腦組織牽拉，降低炎性細(xì)胞因子,，減少繼發(fā)性神經(jīng)功能損害等特點(diǎn),，可縮短患者手術(shù)及住院時(shí)間,，減少并發(fā)癥及醫(yī)療費(fèi)用，提高患者生存質(zhì)量等特點(diǎn),，值得臨床大范圍推廣應(yīng)用,。
Application of channel expansion in minimally invasive surgery for hypertensive intracerebral hemorrhage
CHEN Shang-jun, ZUO Yi, QIAN Chao, et al. Department of Neurosurgery, 215 Hospital of Shanxi Nuclear Industry, Xianyang 712000, China
?Abstract: Objective To develop a special channel expansion device for the operation of hypertensive intracerebral hemorrhage to reduce iatrogenic injury and secondary neurological impairment.
?Methods Two transparent concentric channels of different sizes were overlapped with each other and the front end was shrinked to a cone shape. When it was used, it was entered through the cerebral cortex incision. When the tip of the inner cannula was black, it indicated that it had entered the hematoma cavity. The inner cannula was removed, and the operation was carried out in the outer tube assisted by microscope.
? Results The mean operation time was（95.21±15.12）min, the hematoma clearance rate was（98.24±2.31）%, the length of stay was（20.15±5.04）days, the GOS prognostic score was（4.64±1.42）, the survival rate and quality of life were improved, and the obvious effect was achieved.
? Conclusion The surgery expansion channel is characteristic in lightweight, intuitive, little injury, reducing brain tissue pull, reducing inflammatory cytokines, reducing secondary neurologic damage etc, and can shorten patients with surgery and length of hospital stay, reduce complications and medical costs, improve the quality of survival, etc, is worthy of clinical extensive application.
參考文獻(xiàn)
[1]陳尚軍，左毅,，千超,，張彬，等.通道擴(kuò)張技術(shù)在高血壓腦出血微創(chuàng)手術(shù)中應(yīng)用研究[J].臨床神經(jīng)外科雜志,2022,19(4):450-452.[DOI:10.3969/j.issn.1672-7770.2022.04.018]
[1]CHEN Shang-jun, ZUO Yi, QIAN Chao, et al. Application of channel expansion in minimally invasive surgery for hypertensive intracerebral hemorrhage[J].Journal of Clinical Neurosurgery,2022,19(4):450-452.[DOI:10.3969/j.issn.1672-7770.2022.04.01
