小骨窗外侧裂人路显微手术治疗高血压基底节区脑出血

摘要

Objective To study the clinical effect of microsurgical treatment via lateral fissure approach on hypertensive basal ganglia hemorrhage.Methods Small bone flap via lateral fissure approach were applied to remove basal ganglia hematoma.Thirty two cases were recruited in the retrospective analysis.Results By head CT scan follow-up 24 h post operation,over 80％ percent of hematoma was successfully removed in 28 cases and over 40％ of hematoma was resided in 4 case.Patients were followed up for 3 - 6 months,according to the ADL (ADL)classification,the outcomes were:Grade Ⅰ in 4 cases( 12.5％ ),grade Ⅱ in 13 cases(40.6％ ),grade Ⅲ in 12 cases (37.5％)and grade Ⅳ in 3 cases (9.4％).No death occurred.Conclusion Small window approach on lateral fissure for microsurgical operation of hypertensive basal ganglia hemorrhage is a less invasive procedure with good surgical exposure and homeostasis.Neurological function was well recovered after surgery.%目的 观察显微手术外侧裂入路治疗高血压基底节区脑出血的疗效.方法 对32例高血压基底节区脑出血患者采用小骨窗外侧裂入路显微手术清除血肿.结果 术后24 h复查头颅CT,血肿清除80％以上28例,50％ ～79％3例(9.37％),血肿残余40％ ～ 49％1例.术后随访3～6个月,按日常生活能力(ADL)分级:Ⅰ级4例(12.5％),Ⅱ级13例(40.6％),Ⅲ级12例(37.5％),Ⅳ级3例(9.4％),无死亡病例.结论 小骨窗外侧裂入路显微手术治疗高血压基底节区脑出血创伤小,手术显露满意,止血可靠,术后神经功能恢复良好.