中国医学创新
中國醫學創新
중국의학창신
Medical Innovation of China
2015年
26期
139-142
,共4页
侧裂-岛叶入路%高血压脑出血%基底节区%小骨窗%血肿清除
側裂-島葉入路%高血壓腦齣血%基底節區%小骨窗%血腫清除
측렬-도협입로%고혈압뇌출혈%기저절구%소골창%혈종청제
Lateral fissure-insular approach%Hypertension cerebral hemorrhage%Basal ganglion%Small bone flap craniotomy%Evacuation of hematoma
目的：探讨显微镜下小骨窗联合侧裂-岛叶入路治疗基底节区高血压脑出血的手术要点及疗效。方法：选取本院神经外科2011年1月-2014年1月收治的48例基底节区高血压性脑出血患者，所有患者早期均行显微镜下小骨窗联合侧裂-岛叶入路清除血肿治疗，分析其临床疗效。结果：所有患者术后即刻复查CT示：43例血肿基本清除，5例清除约80%。术后死亡4例，存活44例随访6~18个月，根据GOS评价，良好30例，中残10例，重残3例，死亡1例。结论：显微镜下小骨窗联合侧裂-岛叶入路治疗基底节区高血压脑出血具有微创的优点，术中显露满意，血肿清除较彻底，止血效果好，能够有效降低患者颅内压，同时减少颞叶皮层及血管损伤，术后致死、致残率低，值得在基层推广。
目的：探討顯微鏡下小骨窗聯閤側裂-島葉入路治療基底節區高血壓腦齣血的手術要點及療效。方法：選取本院神經外科2011年1月-2014年1月收治的48例基底節區高血壓性腦齣血患者，所有患者早期均行顯微鏡下小骨窗聯閤側裂-島葉入路清除血腫治療，分析其臨床療效。結果：所有患者術後即刻複查CT示：43例血腫基本清除，5例清除約80%。術後死亡4例，存活44例隨訪6~18箇月，根據GOS評價，良好30例，中殘10例，重殘3例，死亡1例。結論：顯微鏡下小骨窗聯閤側裂-島葉入路治療基底節區高血壓腦齣血具有微創的優點，術中顯露滿意，血腫清除較徹底，止血效果好，能夠有效降低患者顱內壓，同時減少顳葉皮層及血管損傷，術後緻死、緻殘率低，值得在基層推廣。
목적：탐토현미경하소골창연합측렬-도협입로치료기저절구고혈압뇌출혈적수술요점급료효。방법：선취본원신경외과2011년1월-2014년1월수치적48례기저절구고혈압성뇌출혈환자，소유환자조기균행현미경하소골창연합측렬-도협입로청제혈종치료，분석기림상료효。결과：소유환자술후즉각복사CT시：43례혈종기본청제，5례청제약80%。술후사망4례，존활44례수방6~18개월，근거GOS평개，량호30례，중잔10례，중잔3례，사망1례。결론：현미경하소골창연합측렬-도협입로치료기저절구고혈압뇌출혈구유미창적우점，술중현로만의，혈종청제교철저，지혈효과호，능구유효강저환자로내압，동시감소섭협피층급혈관손상，술후치사、치잔솔저，치득재기층추엄。
Objective:To investigate the operative key points and surgical treatment effect of small bone flap craniotomy combined with lateral fissure-insular approach under the microscope in the treatment of hypertensive basal ganglia hemorrhage. Method:48 patients with hypertensive basal ganglia hemorrhage admitted to our hospital from January 2011 to January 2014 were selected,at the early stage,they were given evacuation of hematoma treatment via small bone flap craniotomy combined with lateral fissure-insular approach under the microscope.Its clinical efficacy was analyzed.Result:The CT re-examination after postoperative immediately showed that the hematomas was removed all in 43 patients,over 80% in 5 patients,postoperative died in four patients.After 6 to 18 months follow-up,the GOS was good in 30 patients,mild disability in 10 patients,severe disability in 3 patients and 1 patient died.Conclusion:The treatment of hypertensive basal ganglia hemorrhage via a small bone flap craniotomy combined with lateral fissure-insular approach under the microscope has advantages such as minimal invasive,good exposure,comparatively complete hematomas removal, desirable effect stopping the blood flow,can effectively reduce intracranial pressure,while reducing the temporal lobe cortex and vascular injury,with low morbidity and mortality,is worth popularizing in the grassroots.
