CAJ | 학술논문

目的探索神经内镜高血压脑出血(HICH)微创手术术前精确可靠的手术定位方法.方法南方医科大学珠江医院神经外科自2008年6月至2010年8月通过CT扫描及图像三维重建的方法定位脑内血肿、选择最佳内镜微创手术入路行神经内镜微创术治疗HICH患者18例,分析患者的临床资料和疗效.结果根据CT三维重建结果,术者可以准确设计最佳内镜微创手术入路并实现颅骨钻孔部位的精确定位,减少手术前准备、麻醉及操作时间.本组患者平均手术时间仅1.5 h左右,手术失血量仅30～40mL,血肿清除率约为89.2%,且血肿清除后脑组织松弛,无需行去骨瓣减压.结论 HICH患者采用CT扫描、三维重建进行术前手术定位是一种快速、简便、可靠的神经内镜微创脑出血手术定位方法.
목적 탐색신경내경고혈압뇌출혈(HICH)미창수술술전정학가고적수술정위방법.방법남방의과대학주강의원신경외과자2008년6월지2010년8월통과CT소묘급도상삼유중건적방법정위뇌내혈종、선택최가내경미창수술입로행신경내경미창술치료HICH환자18례,분석환자적림상자료화료효.결과 근거CT삼유중건결과,술자가이준학설계최가내경미창수술입로병실현로골찬공부위적정학정위,감소수술전준비、마취급조작시간.본조환자평균수술시간부1.5 h좌우,수술실혈량부30～40mL,혈종청제솔약위89.2%,차혈종청제후뇌조직송이,무수행거골판감압.결론 HICH환자채용CT소묘、삼유중건진행술전수술정위시일충쾌속、간편、가고적신경내경미창뇌출혈수술정위방법.
Objective To develop a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with hypertensive intracerebral hemorrhage (HICH).Methods Eighteen patients with HICH, admitted to our hospital from June 2008 to August 2010, were performed endoscopic minimally invasive surgery; CT three-dimensional reconstruction was employed to locate the intracerebral hematoma and select the appropriate endoscopic approach before the endoscopic surgery.The clinical data and treatmem efficacy were analyzed.Results According to the results of CT three-dimensional reconstruction, our neurosurgeons could design the best endoscopic approach; the three-dimensional relationship between intracerebral hematoma and scalp markers was shown directly and accurate positioning of the location of drilling was achieved; therefore, the time for preoperative preparation, anesthesia and operation was shortened. The mean operating time of these 18 patients was about 1.5 h; the volume of blood loss was only 30-40 mL; and the evacuation ratio was about 89.2%.After the elimination of hematoma, the brain tissues were flabby, so decompressive craniectomy was not needed. Conclusion CT three-dimensional reconstruction is a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with HICH.