【摘要】
▶ 目的 研制一种高血压脑出血手术专用扩张通道，以减少手术时过度牵拉脑组织，造成不必要的医源性损伤，减轻继发性神经功能损害。
▶ 方法 将两个大小不一的透明扩张通道相互套叠，前端缩小成锥形。使用时从脑组织皮层造瘘口进入，当看到内套管尖端发黑时，表示已进入血肿腔，拔除内套管，显微镜辅助下在外套管内进行手术操作。
▶ 结果 本组患者手术平均时间（95.21±15.12）min，血肿清除率(98.24±2.31)%，住院时间(20.15±5.04)d，GOS预后评分(4.64±1.42)，患者生存率升高，生存质量提高，取得明显效果。
▶ 结论 该手术专用扩张通道具有：轻巧，直观，损伤小，减少脑组织牵拉，降低炎性细胞因子，减少继发性神经功能损害等特点，可缩短患者手术及住院时间，减少并发症及医疗费用，提高患者生存质量等特点，值得临床大范围推广应用。
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.
参考文献
[1]陈尚军，左毅，千超，张彬，等.通道扩张技术在高血压脑出血微创手术中应用研究[J].临床神经外科杂志,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
