安徽医学
安徽醫學
안휘의학
ANHUI MEDICAL JOURNAL
2015年
8期
966-969
,共4页
周良东%夏连贵%陈琳%徐良娣
週良東%夏連貴%陳琳%徐良娣
주량동%하련귀%진림%서량제
小骨窗%高血压%基底神经节%脑出血%外侧裂入路
小骨窗%高血壓%基底神經節%腦齣血%外側裂入路
소골창%고혈압%기저신경절%뇌출혈%외측렬입로
Small craniotomy%Hypertension%Basal ganglia%Intra-cerebral hemorrhage%Trans-sylvian trans-insular approach
目的：探讨直切口小骨窗经侧裂入路显微手术治疗高血压基底节脑出血的方法及疗效。方法对64例高血压基底节脑出血患者的临床资料进行回顾性分析，根据不同手术方法分为观察组（直切口小骨窗经侧裂入路血肿清除术）和对照组（骨瓣开颅皮层入路血肿清除术）。比较两组的手术时间、术中出血量、血肿清除率、术后并发症及住院时间、病死率，日常生活活动能力分级（ADL）。结果观察组手术时间短，术中出血及术后并发症少，住院时间短，两组比较差异有统计学意义（P ﹤0.05），术后1年 ADL 明显优于对照组，差异有统计学意义（P ﹤0.05）。结论对于术前无脑疝及严重高颅压者，直切口小骨窗经侧裂入路显微手术是治疗高血压基底节脑出血较理想的方法，可提高患者存活率，改善生活质量。
目的：探討直切口小骨窗經側裂入路顯微手術治療高血壓基底節腦齣血的方法及療效。方法對64例高血壓基底節腦齣血患者的臨床資料進行迴顧性分析，根據不同手術方法分為觀察組（直切口小骨窗經側裂入路血腫清除術）和對照組（骨瓣開顱皮層入路血腫清除術）。比較兩組的手術時間、術中齣血量、血腫清除率、術後併髮癥及住院時間、病死率，日常生活活動能力分級（ADL）。結果觀察組手術時間短，術中齣血及術後併髮癥少，住院時間短，兩組比較差異有統計學意義（P ﹤0.05），術後1年 ADL 明顯優于對照組，差異有統計學意義（P ﹤0.05）。結論對于術前無腦疝及嚴重高顱壓者，直切口小骨窗經側裂入路顯微手術是治療高血壓基底節腦齣血較理想的方法，可提高患者存活率，改善生活質量。
목적：탐토직절구소골창경측렬입로현미수술치료고혈압기저절뇌출혈적방법급료효。방법대64례고혈압기저절뇌출혈환자적림상자료진행회고성분석，근거불동수술방법분위관찰조（직절구소골창경측렬입로혈종청제술）화대조조（골판개로피층입로혈종청제술）。비교량조적수술시간、술중출혈량、혈종청제솔、술후병발증급주원시간、병사솔，일상생활활동능력분급（ADL）。결과관찰조수술시간단，술중출혈급술후병발증소，주원시간단，량조비교차이유통계학의의（P ﹤0.05），술후1년 ADL 명현우우대조조，차이유통계학의의（P ﹤0.05）。결론대우술전무뇌산급엄중고로압자，직절구소골창경측렬입로현미수술시치료고혈압기저절뇌출혈교이상적방법，가제고환자존활솔，개선생활질량。
Objective To study the method and effect of microsurgical treatment on patients with hypertensive basal ganglia hemato-mas(HBGH)through small craniotomy trans-sylvian approach. Methods The clinical data of 64 cases of HBGH patients underwent micro-surgical treatment in our hospital from 2008 to 2013 were retrospectively analyzed. All the patients were treated with open surgical evacuation through small craniotomy trans-sylvian approach or conventional craniotomy approach,and thereby they were divided intotwo groups. The op-eration time,intra-operative blood loss,hematomas clearance rate,postoperative complications,and hospitalization time,mortality,activities of daily living(ADLs)between the two groups were compared. Results Compared with the conventional craniotomy approach group,the small craniotomy trans-sylvian group had lower blood loss,fewerpostoperative complications,shorter time of operation and hospitalization,and the difference was statistically significant(P ﹤ 0. 05). The ADL grade at 12 months after operation was higher in the small craniotomy trans-sylvian group than that in the conventional craniotomy approach group,similarly with significant difference(P ﹤ 0. 05). Conclusion Micro-surgery through trans-sylvian trans-insular approach is an effective treatment for HBGH patients without cerebral hernia or severe intracranial hypertension,and it is characterized by minimal cerebral tissues injury,high hematomas clearance rate and good prognostic nervous function.
