中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2013年
2期
175-178
,共4页
魏社鹏%赵继宗%周范民%张巍峰%张夔鸣%丁侃%张燕飞%杨成%魏亮
魏社鵬%趙繼宗%週範民%張巍峰%張夔鳴%丁侃%張燕飛%楊成%魏亮
위사붕%조계종%주범민%장외봉%장기명%정간%장연비%양성%위량
高血压脑出血%基底节%并发症%扩大翼点入路%马蹄形切口
高血壓腦齣血%基底節%併髮癥%擴大翼點入路%馬蹄形切口
고혈압뇌출혈%기저절%병발증%확대익점입로%마제형절구
Hypertensive intracerebral hemorrhage%Basal ganglion%Complication%Expanded transpterional approach%Horseshoe-shaped incision
目的 探讨并比较采用两种不同切口开颅清除自发性高血压性基底节脑内血肿后的并发症情况. 方法 回顾性分析同济大学附属上海市东方医院神经外科自2010年1月至2011年12月手术治疗的58例自发性高血压性基底节脑内血肿患者的临床资料,其中A组(手术时间2010年1月至12月底)27例采用扩大翼点入路切口,B组(手术时间2010年12月底至2011年12月)31例采用围绕外耳道的马蹄形切口. 结果 58例患者中术后死亡1例,存活57例；日常生活能力评分为Ⅰ级18例,Ⅱ级26例,Ⅲ级8例,Ⅳ级5例,Ⅴ级1例.A组术后发生硬膜外血肿3例,拆线后耳前动脉喷血1例,皮下积液5例；B组术后均未发生硬膜外血肿,仅有面神经颞支损伤5例；与A组比较,B组具有较少的并发症发生率,差异有统计学意义(x2=4.660,P=0.012). 结论 采用围绕外耳道的马蹄形切口开颅清除自发性高血压性基底节脑内血肿的手术并发症发生率相对较低.
目的 探討併比較採用兩種不同切口開顱清除自髮性高血壓性基底節腦內血腫後的併髮癥情況. 方法 迴顧性分析同濟大學附屬上海市東方醫院神經外科自2010年1月至2011年12月手術治療的58例自髮性高血壓性基底節腦內血腫患者的臨床資料,其中A組(手術時間2010年1月至12月底)27例採用擴大翼點入路切口,B組(手術時間2010年12月底至2011年12月)31例採用圍繞外耳道的馬蹄形切口. 結果 58例患者中術後死亡1例,存活57例；日常生活能力評分為Ⅰ級18例,Ⅱ級26例,Ⅲ級8例,Ⅳ級5例,Ⅴ級1例.A組術後髮生硬膜外血腫3例,拆線後耳前動脈噴血1例,皮下積液5例；B組術後均未髮生硬膜外血腫,僅有麵神經顳支損傷5例；與A組比較,B組具有較少的併髮癥髮生率,差異有統計學意義(x2=4.660,P=0.012). 結論 採用圍繞外耳道的馬蹄形切口開顱清除自髮性高血壓性基底節腦內血腫的手術併髮癥髮生率相對較低.
목적 탐토병비교채용량충불동절구개로청제자발성고혈압성기저절뇌내혈종후적병발증정황. 방법 회고성분석동제대학부속상해시동방의원신경외과자2010년1월지2011년12월수술치료적58례자발성고혈압성기저절뇌내혈종환자적림상자료,기중A조(수술시간2010년1월지12월저)27례채용확대익점입로절구,B조(수술시간2010년12월저지2011년12월)31례채용위요외이도적마제형절구. 결과 58례환자중술후사망1례,존활57례；일상생활능력평분위Ⅰ급18례,Ⅱ급26례,Ⅲ급8례,Ⅳ급5례,Ⅴ급1례.A조술후발생경막외혈종3례,탁선후이전동맥분혈1례,피하적액5례；B조술후균미발생경막외혈종,부유면신경섭지손상5례；여A조비교,B조구유교소적병발증발생솔,차이유통계학의의(x2=4.660,P=0.012). 결론 채용위요외이도적마제형절구개로청제자발성고혈압성기저절뇌내혈종적수술병발증발생솔상대교저.
Objective To compare the complications of spontaneous hypertensive intracerebral hematoma located in the basal ganglion after being treated with two different incision craniotomies.Methods The clinical data of 58 patients with spontaneous hypertensive intracerebral hematoma located in the basal ganglion,admitted to our hospital and performed hematoma resection from January 2010 to December 2011,were retrospectively analyzed; in these 58 patients,27 (group A) adopted expanded transpterional approach and the other 31 (group B) chose horseshoe-shaped incision around the extemal auditory canal.Results In all these 58 patients,one patient died and 57 survived.According to the activity of daily living test,18,26,8,5 and 1 patients were in grade Ⅰ,grade Ⅱ,grade Ⅲ,grade Ⅳ and grade Ⅴ,respectively.The complications of group A were as follows:epidural hematoma was noted in 3patients; blood spurting of the superficial temporal artery after being removed the stitches in 1 patient,and subcutaneous hydrops in 5 patients; the complications in group B only included temporal facial nerve injuries in 5 patients; the complication rate in group A was significantly higher than that in group B (x2=4.660,P=0.012).Conclusion Removal of hematoma of the basal ganglion using horseshoe-shaped incision craniotomy is the appropriate method enjoying fewer complications.
