中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2018, Vol. 13 ›› Issue (6): 999-1006.doi: 10.4103/1673-5374.233442

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

神经内镜通道内操作技术：快速清除急性重症脑室内血肿的新方法

  

  • 收稿日期:2018-05-12 出版日期:2018-06-15 发布日期:2018-06-15
  • 基金资助:

    深圳市卫计委临床研究项目（SZLY2018007），深圳市科技计划项目（JCYJ 20150403101028210），南方医科大学科技发展培养项目（KJ 20161115），广东省医学研究基金项目（A2016545），深圳市卫计委研究基金（201601013, 201506009）

The intra-neuroendoscopic technique: a new method for rapid removal of acute severe intraventricular hematoma

Bo Du1, 2, Ai-Jun Shan2, Yu-Juan Zhang2, Jin Wang2, Kai-Wen Peng1, Xian-Liang Zhong2, Yu-Ping Peng1   

  1. 1 Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
    2 Department of Emergency Medicine, Shenzhen People’s Hospital, The Second Affiliated Hospital of Jinan University, Shenzhen, Guangdong Province, China
  • Received:2018-05-12 Online:2018-06-15 Published:2018-06-15
  • Contact: Yu-Ping Peng,42104679@qq.com.
  • Supported by:

    This study was funded by a grant from the Clinical Research Project of Shenzhen Health and Family Planning Commission in China,No. SZLY2018007; a grant from the Science and Technology Planning Project of Shenzhen City of China, No. JCYJ 20150403101028210; a grant from the Science and Technology Development and Cultivation Project of Southern Medical University of China, No. KJ 20161115; the Guangdong Provincial Medical Research Fund in China, No. A2016545; and the Shenzhen Health Planning Commission Research Fund in China, No. 201601013, 201506009.

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摘要：

 

重度脑室内血肿患者的死亡率高，生存者致残率高，一直是困扰临床治疗的难题，应用微创内镜可清除血肿，但其技术仍有改进空间。2项神经内镜通道内技术透明导管鞘-专利号：ZL 200820046232.0），血肿碎吸器-专利号：ZL 201520248717.8是作者所在团队拥有的中国实用专利产品构成的新技术，试验拟通过基于这2项专利构成的新技术与传统治疗方法（脑室外引流+尿激酶纤溶治疗）进行比较其有效性和安全性。试验招募了65例重度脑室系统积血患者，其中35例(19男/16女，53.2±8.7岁)接受神经内镜通道内技术治疗，另30例(17男/13女，51.5±7.9岁)接受脑室外引流+尿激酶纤溶治疗。结果显示了与传统方法治疗的患者相比，神经内镜通道内技术治疗的患者脑室内血肿的手术清除率提高，ICU住院时间及脑室外引流管拔除时间缩短，颅内感染发生率、二次出血的发生率以及死亡率降低，生存在预后的功能改善明显。表明神经内镜通道内技术是一种安全有效的治疗重症脑室内血肿的新方法。试验已在ClinicalTrials.gov注册(注册号NCT 02515903).

orcid:0000-0003-1217-190X(Bo Du)

关键词: 脑室出血, 透明导管鞘, 脑室外引流, 微创手术, 新型技术, 尿激酶溶栓, 预后, 神经再生

Abstract:

The mortality rate of acute severe intraventricular hematoma is extremely high, and the rate of disability in survivors is high. Intraventricular hematoma has always been a difficult problem for clinical treatment. Although minimally invasive endoscopic hematoma evacuation is widely used to treat this disease, the technique still has room for improvement. Equipment for the intra-neuroendoscopic technique (INET) consists of two of our patented inventions: a transparent sheath (Patent No. ZL 200820046232.0) and a hematoma aspirator (Patent No. ZL 201520248717.8). This study explored the safety and efficacy of INET by comparing it with extraventricular drainage in combination with urokinase thrombolytic therapy. This trial recruited 65 patients with severe intraventricular hemorrhage, including 35 (19 men and 16 women, aged 53.2 ± 8.7 years) in the INET group and 30 (17 men and 13 women, aged 51.5 ± 7.9 years) in the control group (extraventricular drainage plus urokinase thrombolytic therapy). Our results showed that compared with the control group, the INET group exhibited lower intraventricular hemorrhage volumes, shorter intensive care-unit monitoring and ventricular drainage-tube placement times, and fewer incidences of intracranial infection, secondary bleeding, and mortality. Thus, the prognosis of survivors had improved remarkably. These findings indicate that INET is a safe and efficient new method for treating severe intraventricular hematoma. This trial was registered with ClinicalTrials.gov (NCT02515903).

Key words: nerve regeneration, ventricular hemorrhage, transparent sheath, extraventricular drainage, minimally invasive surgery, intra-neuroendoscopic technique, urokinase thrombolysis, prognosis, neural regeneration