高血压脑出血的微创外科手术治疗进展

Progress in Minimally Invasive Surgical Treatment of Hypertensive Intracerebral Hemorrhage

摘要: 高血压脑出血是最常见的自发性脑出血，目前治疗分为外科治疗和内科治疗，治疗原则主要是降低颅内压，减少血肿对脑组织的压迫。随着科技的发展我们对外科微创手术越来越受到推崇，本文将以国内外有关自发性脑出血中的高血压脑出血国内外微创手术治疗进展进行叙述，微创手术的术式和手术时机，分别概述了现行的微创术式和一些结合影像引导的术式，传统微创穿刺以及影像辅助下的神经内镜微创手术、3D激光联合C臂CT引导穿刺引流、3D打印导板辅助引流穿刺、AR (Augmented reality)辅助引流穿刺术。但这些术式需要更多的大型、前瞻性、随机试验来研究其可靠性，为患者提供更优质的治疗，减轻患者的病痛，改善预后。

Abstract: Hypertensive cerebral hemorrhage is the most common spontaneous cerebral hemorrhage. At present, the treatment is divided into surgical treatment and medical treatment. The principle of treatment is mainly to reduce intracranial pressure and reduce the compression of hematoma on brain tissue. With the development of science and technology, we are more and more respected for surgical minimally invasive surgery. This article will describe the progress of minimally invasive surgery for hypertensive intracerebral hemorrhage in spontaneous intracerebral hemorrhage at home and abroad. The surgical procedures and surgical timing of minimally invasive surgery are summarized respectively. The current minimally invasive surgery and some combined with image-guided surgery, traditional minimally invasive puncture and image-assisted neuroen-doscopic minimally invasive surgery, 3D laser combined with C-arm CT-guided puncture drainage, 3D printed guide-assisted drainage puncture, AR (Augmented reality) assisted drainage puncture. However, these surgical procedures require larger, prospective, randomized trials to study their reliability, provide better treatment for patients, reduce patients’ pain, and improve prognosis.