简易套管辅助可视化内镜下脑血肿清除术

doi:10.3969/j.issn.1009-976X.2026.03.006

岭南现代临床外科 ›› 2026, Vol. 26 ›› Issue (03): 176-183.DOI: 10.3969/j.issn.1009-976X.2026.03.006

简易套管辅助可视化内镜下脑血肿清除术

马光铄^1,2, 张晓慧¹, 曹建平¹, 高超¹, 侯文蛟², 刘博², 常斌鸽^1*

1.天津市第一中心医院神经外科,天津 300393;
2.新疆生产建设兵团第四师医院神经外科,新疆伊宁 835000

通讯作者: *常斌鸽,Email：changcheng1988@sina.com
基金资助:
天津市医学重点学科建设（TJYXZDXK-3-002A-3）

Simplified tubular retractor-assisted visualized endoscopic surgery of intracerebral hematomas

MA Guangshuo^1,2, ZHANG Xiaohui¹, CAO Jianping¹, GAO Chao¹, HOU Wenjiao², LIU Bo², CHANG Bin′ge^1*

1. Department of Neurosurgery, Tianjin First Central Hospital, Tianjin, 300000, China;
2. Department of Neurosurgery, Xinjiang Production and Construction Corps Fourth Division Hospital, Yining, Xinjiang 835000, China

Received:2026-04-16 Online:2026-06-20 Published:2026-08-10
Contact: *CHANG Bin′ge, changcheng1988@sina.com

摘要/Abstract

摘要： 目的介绍一种脑出血手术中的简易套管,并分析可视化神经内镜下脑血肿清除术的效果。方法回顾2024年6月至2025年10月共32例脑出血患者的神经内镜下血肿清除术资料。术中利用注射器、手套及一次性腰椎穿刺包制作简易套管,配合神经内镜进行可视化通道建立,并行直视下血肿清除。对其临床效果进行分析。结果本组32例脑出血患者血肿平均清除率为80.4%,明显瘘道内血肿2例,二次开颅手术1例。结论自制简易套管辅助可视化神经内镜下脑血肿清除术具有一定可行性和潜在应用价值。

关键词: 套管, 可视化, 内镜, 脑出血

Abstract: Objective To introduce a simplified tubular retractor for intracerebral hemorrhage surgery and analyze the efficacy of visualized neuroendoscopic hematoma evacuation. Methods Review and analyze the data of neuroendoscopic hematoma evacuation in 32 cases of intracerebral hemorrhage from June 2024 to October 2025. A simple cannula was intraoperatively fabricated using syringes, gloves, and disposable lumbar puncture kits to assist in establishing a visualized channel under neuroendoscopy, followed by direct-view hematoma evacuation. The clinical outcomes were evaluated. Results In this group, 32 patients with cerebral hemorrhage had an average hematoma clearance rate of 80.4%, with 2 cases of obvious hematoma within the fistula and 1 case of secondary craniotomy. Conclusion The self-made simplified tubular retractor-assisted visualized neuroendoscopic hematoma evacuation has certain feasibility and potential application value.

Key words: tubular retractor, visualization, endoscopy, intracerebral hemorrhage

中图分类号:

马光铄, 张晓慧, 曹建平, 高超, 侯文蛟, 刘博, 常斌鸽. 简易套管辅助可视化内镜下脑血肿清除术[J]. 岭南现代临床外科, 2026, 26(03): 176-183.

MA Guangshuo, ZHANG Xiaohui, CAO Jianping, GAO Chao, HOU Wenjiao, LIU Bo, CHANG Bin′ge. Simplified tubular retractor-assisted visualized endoscopic surgery of intracerebral hematomas[J]. Lingnan Modern Clinics In Surgery, 2026, 26(03): 176-183.

参考文献

[1] 骆明涛, 伍聪, 陶传元, 等. 《高血压性脑出血中国多学科诊治指南》急救诊治解读[J]. 中国急救医学, 2021, 41(3): 185-190.
[2] Greenberg SM, Ziai WC, Cordonnier C, et al.2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association[J]. Stroke, 2022, 53(7): e282-e361.
[3] Liu S, Long J, Cao S, et al.Endoport Assisted Endoscopic Surgery for Hypertensive Basal Ganglia Hemorrhage by Transsylvian Approach: Technical Nuances and Preliminary Clinical Results[J]. World Neurosurg, 2023, 179:e593-e600.
[4] Al-Kawaz MN, Hanley DF, Ziai W.Advances in Therapeutic Approaches for Spontaneous Intracerebral Hemorrhage[J]. Neurotherapeutics, 2020, 17(4): 1757-1767.
[5] Gross BA, Jankowitz BT, Friedlander RM.Cerebral Intraparenchymal Hemorrhage: A Review[J]. JAMA, 2019, 321(13): 1295-1303.
[6] Chu J, Qiu Y, Zhou Q, et al.Neutrophils in Intracerebral Hemorrhage: Roles, Mechanisms, and Therapeutic Implications[J]. Mediators Inflamm, 2025, 2025: 6650301.
[7] Schrag M, Kirshner H.Management of Intracerebral Hemorrhage: JACC Focus Seminar[J]. J Am Coll Cardiol, 2020, 75(15): 1819-1831.
[8] Yu Z, Tao C, Xiao A, et al.Chinese multidisciplinary guideline for management of hypertensive intracerebral hemorrhage[J]. Chin Med J (Engl), 2022, 135(19): 2269-2271.
[9] Scaggiante J, Zhang X, Mocco J, et al.Minimally Invasive Surgery for Intracerebral Hemorrhage[J]. Stroke, 2018, 49: 2612-2620.
[10] Murthy SB.Emergent Management of Intracerebral Hemorrhage[J]. Continuum (Minneap Minn), 2024, 30(3): 641-661.
[11] 邹桂连, 赵晗文, 张灿灿, 等. 微创治疗脑出血:神经内镜技术创新与临床实践的结合[J]. 空军军医大学学报, 2025, 46(9): 1186-1190.
[12] Singh H, Patir R, Vaishya S, et al.Syringe Port: A Convenient, Safe, and Cost-Effective Tubular Retractor for Transportal Removal of Deep-Seated Lesions of the Brain[J]. World Neurosurg, 2018, 114: 117-120.
[13] Zhenzhu L, Ruiyu X, Wei C, et al. Novel Cost-Effective Tubular Port Based on Glove and Syringe for Endoscopic Surgery of Intracerebral Hematomas[J]. World Neurosurg, 2020, 135: 367-374. e1.
[14] Orlev A, Kimchi G, Oxman L, et al.Minimally Invasive Intracerebral Hematoma Evacuation Using a Novel Cost-Effective Tubular Retractor: Single-Center Experience[J]. World Neurosurg, 2021, 150: 42-53.
[15] Wei J, Tian Y, Zhang Y, et al.Short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage[J]. World J Clin Cases, 2021, 9(28): 8358-8365.
[16] Zhan Y, Zou X, Wu J, et al.Neuroendoscopy surgery for hypertensive intracerebral hemorrhage with concurrent brain herniation: a retrospective study of comparison with craniotomy[J]. Front Neurol, 2023, 14: 1238283.
[17] Cindea C, Saceleanu V, Tudor V, et al.Prognostic Factors and Clinical Outcomes of Spontaneous Intracerebral Hemorrhage: Analysis of 601 Consecutive Patients from a Single Center (2017-2023)[J]. NeuroSci, 2025, 6(3): 77.

简易套管辅助可视化内镜下脑血肿清除术

Simplified tubular retractor-assisted visualized endoscopic surgery of intracerebral hematomas

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