目的 探讨采用经外侧裂-岛叶入路显微手术结合颅内压监测治疗基底节区高血压脑出血的临床疗效.方法 回顾性分析采用经外侧裂-岛叶入路显微手术结合颅内压监测治疗的35例基底节区高血压脑出血患者的临床资料.结果 本组患者中,死亡3例,存活32例;术后随访3~6个月,根据日常生活能力分级评定,其中Ⅰ级者8例、Ⅱ级11例、Ⅲ级6例、Ⅳ4例、Ⅴ级3例,本组患者总的良好预后率为71.4%(25/35).结论 采用经外侧裂-岛叶入路显微手术结合颅内压监测治疗基底节区高血压脑出血(血肿量>30 ml),是较为安全有效的治疗方法.针对不同的患者选择合适的手术时机,个体化、精准化治疗,有助于手术安全有效及患者神经功能的恢复,改善患者的预后.%Objective To explore the effects of microsurgical treatment through lateral fissure and insular lobe approach and ICP monitoring for hypertensive basal ganglia hemorrhage.Methods The clinical data of 35 patients who received microsurgical treatment through lateral fissure approach for hypertensive basal ganglia hemorrhag were analyzed retrospectively.Results Of 35 patients,3 were dead and 32 were survival after the follow-up from 3 to 6 months,and according to the ADL classification,8 belonged in the grade I,11 in gradeⅡ,6 in the grade Ⅲ,4 in the grade Ⅳ and 3 in the grade Ⅴ.The ADL was good in 25 patients (71.4%).Conclusion The microsurgical treatment via lateral fissure insular approach combined with intracranial pressure monitoring in the treatment of hypertensive basal ganglia hemorrhage ( hematoma volume >30 ml ) is safe and effective,according to different patients to choose the appropriate operative opportunities and individualized accurate treatment,ensure the operation is safe and effective,can help the recovery of neural function in patients and improve the prognosis of patients.
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