内镜脑血肿清除工作通道及其应用进展
范学政1 易剑波1 游潮2
1. 中国科学院大学深圳医院神经外科2. 四川大学华西医院神经外科
摘要：随着内镜质量提高和微创理念的深入，内镜血肿清除技术已经成为目前微创治疗脑出血的主要方法。手术时需要专门工作通道进入血肿腔，以便内镜镜头及镜体进入工作通道内完成操作，内镜起照明或观察作用，血肿清除、止血等操作都在工作通道内完成。理想的工作通道应该具有无毒、轻巧、微创等特点。目前有多种研发成果已经用于临床的工作通道，多为医用硅胶材质，直径在2 cm以内的圆筒形状、头端圆钝无切割特点的设计，而且管壁透明易于观察周围情况，极大地方便了内镜血肿清除手术的开展。本文就多种内镜工作通道的特点及其在血肿清除中的作用进行综述。
关键词：脑出血;血肿清除;神经内镜;工作通道;微创;
Application progress of working channels in neuro-endoscopic intracerebral hematoma evacuation①
FAN Xuezheng1,YI Jianbo1,YOU Chao2.(1. Dept. of Neurosurgery,University of Chinese Academy of Sciences Shenzhen Hospital,Shenzhen 518106;2. Dept. of Neurosurgery,West China Hospital of Sichuan University,Chengdu 610041,China)
Abstract With the improvement of neuro-endoscopic quality and the deepening of minimally invasive concept, neuro-endoscopic intracerebral hematoma evacuation has become the key way of minimally invasive treatment of intracerebral hemorrhage. During the operation, a special working channel is required to enter the hematoma cavity, so that the endoscopic lens and body can enter the working channel to complete the operation. The endoscope plays the role of illumination or observation, and hematoma removal and hemostasis are all completed in the working channel. The ideal working channel should be non-toxic, lightweight, and minimally invasive. At present, a variety of research and development achievements have been used in clinical work channels. Most of them are made of medical silicone materials, with a cylindrical shape of less than 2 cm in diameter and a design with round and blunt head without cutting characteristics. Moreover, it is easy to observe the surrounding conditions because of the transparent tube wall, which greatly facilitates the development of endoscopic hematoma removal surgery. Authors in this article review the characteristics of various working channels currently in use, and their roles in endoscopic hematoma removal surgery.
Keywords: cerebral hemorrhage; hematoma evacuation; neuro-endoscope; working channel; minimally invasive
