CAJ | 학술논문

目的探讨经外侧裂入路基底节区高血压脑出血手术U型切口的改良方法及临床意义. 方法自2007年8月至2012年7月解放军第四二一医院神经外科采用经外侧裂岛叶入路清除基底节区高血压脑出血患者共52例(发病后7h内手术28例,7～24 h手术18例,大于24 h手术6例),手术中为更好暴露外侧裂长度,采取前斜30°U型皮瓣形成椭圆形骨窗,骨窗后部过外侧裂中部之后. 结果术后24 h内复查头颅CT示血肿彻底清除42例,血肿残留量＜10mL 6例,血肿残留量＞10 mL4例.术后7d内死亡6例,均为严重肺部感染.存活的46例患者术后6个月GOS评分为良好28例、中残11例、重残3例、植物生存2例、死亡2例. 结论对基底节区高血压脑出血患者采取改良切口经外侧裂入路清除血肿,可以减少手术时间,提高血肿清除率.
목적 탐토경외측렬입로기저절구고혈압뇌출혈수술U형절구적개량방법급림상의의. 방법 자2007년8월지2012년7월해방군제사이일의원신경외과채용경외측렬도협입로청제기저절구고혈압뇌출혈환자공52례(발병후7h내수술28례,7～24 h수술18례,대우24 h수술6례),수술중위경호폭로외측렬장도,채취전사30°U형피판형성타원형골창,골창후부과외측렬중부지후. 결과 술후24 h내복사두로CT시혈종철저청제42례,혈종잔류량＜10mL 6례,혈종잔류량＞10 mL4례.술후7d내사망6례,균위엄중폐부감염.존활적46례환자술후6개월GOS평분위량호28례、중잔11례、중잔3례、식물생존2례、사망2례. 결론 대기저절구고혈압뇌출혈환자채취개량절구경외측렬입로청제혈종,가이감소수술시간,제고혈종청제솔.
Objective To discuss a modified U-shaped incision method for lateral fissure approach to operate hypertensive basal ganglia hemorrhage and its clinical significance.Methods Fifty-two patients,admitted to and performed removal of hypertensive basal ganglia hematomas via lateral fissure by using U modified incision and small bone craniotomy in our hospital from August 2007 to July 2012,were chosen in our study; the operating time from onset to operation was within 7 hours in 28 patients,between 7-24 h in 18 patients,and longer than 24 h in 6 patients.Results Twenty-four hours after the operation,head CT showed that complete evacuation of hematoma was achieved in 42 patients,hematoma residues smaller than 10 mL in 6 patients and larger than 10 mL in 4 patients.Serious pulmonary infection resulted in death in 6 patients within 7 days of operation.GOS 6 months after operation indicated that good recovery was noted in 28 patients,moderate disability in 11,severe disability in 3,vegetative state in 2 and death in 2.Conclusion A modified U-shaped incision for lateral fissure approach to operate hypertensive basal ganglia hemorrhage can improve the hematoma clearance rate and reduce the operating time.