中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
Chinese Journal of Neuromedicine
2015年
10期
1059-1061
,共3页
锁孔手术%老年人%基底节%血肿
鎖孔手術%老年人%基底節%血腫
쇄공수술%노년인%기저절%혈종
Keyhole microsurgery%The elderly%Basal ganglia%Hematoma
目的 探讨锁孔手术清除老年患者基底节区血肿的临床效果. 方法 回顾性分析重庆市江津区中心医院神经外科自2011年3月至2015年1月经锁孔手术治疗的39例老年患者的临床资料、手术方法及效果.所有患者根据术前CT提示的血肿颞部体表投影行锁孔手术清除血肿. 结果 术后颅脑CT扫描血肿清除率为93％,其中血肿直径3.6～6 cm清除率为97％,血肿直径大于6 cm血肿清除率为85％.再出血2例,血肿周边脑梗死1例.术后6月按GOS预后评分评估,恢复较好15例(38.46％),轻度残疾5例(12.82％),中度残疾7例(17.95％),重度残疾3例(7.69％),死亡9例(23.07％). 结论 锁孔手术清除基底节区血肿入路快,手术时间短,失血少,脑皮质损伤小,对老年患者内环境干扰小,医源性创伤小.
目的 探討鎖孔手術清除老年患者基底節區血腫的臨床效果. 方法 迴顧性分析重慶市江津區中心醫院神經外科自2011年3月至2015年1月經鎖孔手術治療的39例老年患者的臨床資料、手術方法及效果.所有患者根據術前CT提示的血腫顳部體錶投影行鎖孔手術清除血腫. 結果 術後顱腦CT掃描血腫清除率為93％,其中血腫直徑3.6～6 cm清除率為97％,血腫直徑大于6 cm血腫清除率為85％.再齣血2例,血腫週邊腦梗死1例.術後6月按GOS預後評分評估,恢複較好15例(38.46％),輕度殘疾5例(12.82％),中度殘疾7例(17.95％),重度殘疾3例(7.69％),死亡9例(23.07％). 結論 鎖孔手術清除基底節區血腫入路快,手術時間短,失血少,腦皮質損傷小,對老年患者內環境榦擾小,醫源性創傷小.
목적 탐토쇄공수술청제노년환자기저절구혈종적림상효과. 방법 회고성분석중경시강진구중심의원신경외과자2011년3월지2015년1월경쇄공수술치료적39례노년환자적림상자료、수술방법급효과.소유환자근거술전CT제시적혈종섭부체표투영행쇄공수술청제혈종. 결과 술후로뇌CT소묘혈종청제솔위93％,기중혈종직경3.6～6 cm청제솔위97％,혈종직경대우6 cm혈종청제솔위85％.재출혈2례,혈종주변뇌경사1례.술후6월안GOS예후평분평고,회복교호15례(38.46％),경도잔질5례(12.82％),중도잔질7례(17.95％),중도잔질3례(7.69％),사망9례(23.07％). 결론 쇄공수술청제기저절구혈종입로쾌,수술시간단,실혈소,뇌피질손상소,대노년환자내배경간우소,의원성창상소.
Objective To investigate the effect of evacuation of basal ganglia hematoma in elderly patients via keyhole approach.Methods Thirty-nine elderly patients with basal ganglia hematoma, admitted to our hospital from March 2011 and January 2011 and underwent keyhole microsurgery, were chosen in our study;and the clinical data, surgical methods and efficacy were retrospectively analyzed.Results According to the surface projection of hematoma tempus by preoperative CT, the surgery via keyhole approach was performed.The postoperative CT scan showed that the removal rate of all hematomas was 93％, removal rate ofhematomas with diameter ranged from 3.6 to 6 cm was 97％, and that of hematomas with diameter exceeded to 6 cm was 85％.Re-bleeding was noted in two patients and cerebral infarction of hematoma periphery was noted in one patient.Glasgow outcome scale scores 6 months after operation indicated good results in 15 patients (38.46％), mild disability in 5 (12.82％), moderate disability in 7 (17.95％), severe disability in 3 (7.69％), and death in 9 (23.07％).Conclusion Evacuation of basal ganglia hematoma in elderly patients via keyhole approach has advantages as fast approach, short operation time, small volume of bleeding, and small damage to the cerebral cortex.
