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目的 :探讨高血压性脑出血微创手术治疗的新方法。方法 :采用单纯颅骨钻孔 ,应用硬质神经内窥镜治疗高血压性脑出血共 2 1例。其中包括脑实质内出血 18例和脑室内出血 3例。结果 :手术时间 5 5～ 115min ,平均 75min。 18例脑实质内出血血肿清除 5 0 %者 4例 ,5 0 %～ 70 %者 10例 ,70 %～ 90 %者 4例 ;3例脑室内出血清除均在 90 %以上。未发现术后血肿。术后显著好转者和好转者 14例 ,无变化者 3例 ,死亡 4例。结论 :应用神经内窥镜清除脑内血肿 ,具有直视下操作、手术时间短、手术创伤小、血肿清除效率高和术后疗效好等优点。术后应用尿激酶灌注有助于巩固术后疗效
Objective: To explore a new method of minimally invasive surgery for hypertensive intracerebral hemorrhage. Methods: A total of 21 cases of hypertensive intracerebral hemorrhage were treated with rigid endoscopic neurosurgery using simple skull drilling. Including 18 cases of intraparenchymal hemorrhage and intraventricular hemorrhage in 3 cases. Results: The operation time was 5 5 ~ 115 minutes, with an average of 75 minutes. 18 cases of intracerebral hemorrhage hematoma 50% were removed in 4 cases, 50% to 70% in 10 cases, 70% to 90% in 4 cases; 3 cases of intraventricular hemorrhage were more than 90%. No postoperative hematoma was found. There were 14 cases of significant improvement and improvement after operation, 3 cases of no change and 4 cases of death. Conclusion: The use of neuroendoscopy in the treatment of intracerebral hematoma has the advantages of direct vision, short operative time, small trauma, high efficiency of hematoma removal and good postoperative efficacy. Postoperative urokinase infusion helps to consolidate postoperative efficacy