CAJ | 학술논문

目的：对比显微镜下从外侧裂入路与常规经皮质入路手术治疗基底节区脑出血的优势和劣势,并分析手术治疗该病的入路选择。方法回顾分析我科2012年5月~2014年5月200例基底节区脑出血达到外科开颅血肿除术指征患者各100例,采取两种不同入路(即从外侧裂或经皮质常规入路)经治疗后,并对比和分析经这两种入路手术方法治疗的两组患者的预后。结果随访半年以上,常规入路治疗100例病人85例生活可以自理,8例生活需人照顾,3例死亡,4例因效果不佳,治疗时间及费用问题,家属放弃治疗；经外侧裂显微入路治疗100例,87例生活可自理,9例需人照顾,2例死亡,2例放弃治疗。结论两种手术入路各有其优势和劣势,其选择要根据患者术前病情轻重缓急而决定,正确的手术入路对患者预后有明显的改善,而不是盲目地一味选择经外侧裂入路。
목적：대비현미경하종외측렬입로여상규경피질입로수술치료기저절구뇌출혈적우세화열세,병분석수술치료해병적입로선택。방법회고분석아과2012년5월~2014년5월200례기저절구뇌출혈체도외과개로혈종제술지정환자각100례,채취량충불동입로(즉종외측렬혹경피질상규입로)경치료후,병대비화분석경저량충입로수술방법치료적량조환자적예후。결과수방반년이상,상규입로치료100례병인85례생활가이자리,8례생활수인조고,3례사망,4례인효과불가,치료시간급비용문제,가속방기치료；경외측렬현미입로치료100례,87례생활가자리,9례수인조고,2례사망,2례방기치료。결론량충수술입로각유기우세화열세,기선택요근거환자술전병정경중완급이결정,정학적수술입로대환자예후유명현적개선,이불시맹목지일미선택경외측렬입로。
Objective To investigate the advantages and disadvantages of the lateral fissure approach and conven-tional approach ,and to choose the right approach to treat the cerebral hemorrhage in basal ganglia patients. Methods 200 patients with cerebral hemorrhage in the basal ganglia area were retrospectively analyzed,two approach of operation were used in the patients who got the cerebral hemorrhage in the basal ganglia region ( operation via lateral fissure approach or conventional approach) ,respectively. Results Following up half year or more after operation,among patients with con-ventional approach,85 can take care of themselves,8 need to be cared for,3 were dead,4 gave up treatment due to all kinds of reasons;among patients with microneurosurgery,87 can take care of themselves,9 need to be cared for,2 were dead,2 gave up treating. Conclusion Two surgical approaches have their advantages and disadvantages,respectively. The select-ed surgical approach was determined by the preoperative condition and prognosis,rather than blindly choosing microsurgery via a lateral fissure approach.