从解剖清除到功能保护：神经内镜技术在高原地区丘脑出血治疗中的角色深化

From Anatomical Resection to Functional Preservation: The Evolving Role of Neuroendoscopy for Thalamic Hemorrhage in High-Altitude Areas

摘要: 丘脑出血作为一种严重的脑出血类型，其治疗难度在高原地区尤为突出，主要由于该地区特殊的环境因素和人体的生理适应性带来的复杂病理变化。传统治疗多侧重于解剖学上的血肿清除，但忽视了神经功能的保护，导致患者预后不理想。近年来，神经内镜技术以其微创和精准的优势逐渐应用于丘脑出血的治疗，推动了治疗理念从单纯的血肿清除向功能保护转变。本文系统综述了神经内镜技术在高原地区丘脑出血治疗中的最新进展，结合高原环境下的病理生理特点，重点分析了技术应用中的挑战与突破，以及相关神经保护策略的演变。通过总结当前研究成果，本文旨在为临床实践提供理论依据和技术指导，推动高原地区丘脑出血的治疗水平不断提升。

Abstract: Thalamic hemorrhage, a severe form of cerebral hemorrhage, is particularly challenging to treat in high-altitude regions. This difficulty stems from complex pathological changes caused by the unique environmental factors and physiological adaptations of the body in such areas. Traditional treatments have focused mainly on anatomical evacuation of the hematoma, often neglecting the preservation of neurological function, which leads to suboptimal patient outcomes. In recent years, minimally invasive and precise neuroendoscopic techniques have gained traction in managing thalamic hemorrhage, driving a shift in therapeutic philosophy from mere hematoma removal toward functional preservation. This paper systematically reviews the latest advances in neuroendoscopy for treating thalamic hemorrhage in high-altitude regions. By integrating the pathophysiological features of the high-altitude environment, it highlights the challenges and breakthroughs in technical applications, as well as the evolution of related neuroprotective strategies. Through a synthesis of current research, this review aims to offer theoretical foundations and practical guidance for clinical practice, ultimately helping to advance treatment standards for thalamic hemorrhage in high-altitude areas.