天津医药

• 论著 • 上一篇    下一篇

超早期小骨窗经侧裂-岛叶入路治疗高血压基底节区脑出血

刘诤,王峰,孙涛,李宗正,徐军,齐江华,剡将术   

  1. 宁夏医科大学附属医院
  • 收稿日期:2010-04-09 修回日期:2010-07-16 出版日期:2010-12-15 发布日期:2010-12-15
  • 通讯作者: 孙涛

The Clinical Research of Super Early Stage Transsyvian Transinsular Approach on Hypertensive- Cerebral Hemorrhage in Basal Ganglia Regions

  • Received:2010-04-09 Revised:2010-07-16 Published:2010-12-15 Online:2010-12-15

PDF (PC)

2190

摘要：  目的:探讨高血压基底节区脑出血新的微创手术治疗方法和疗效。方法:对21例高血压基底节区脑出血患者在发病超早期(≤7h)内采用小骨窗经侧裂-岛叶入路,在显微镜下分离侧裂池,切开岛叶皮层,清除血肿。术后2d复查颅脑CT与原病灶对比,观察血肿清除情况;随访3～12个月,按日常生活能力(ADL)分级法评定预后疗效。结果:血肿清除率>90%者18例,80%～90%者3例。术后存活20例,ADL分级Ⅰ级4例,Ⅱ级12例,Ⅲ级3例,Ⅳ级1例,V级0例,死亡1例。结论:超早期小骨窗经侧裂-岛叶入路治疗高血压基底节区脑出血手术时间短、手术路径小、疗效确切。 

关键词: 高血压, 颅内出血, 高血压性, 脑血管基底神经节出血, 微创性, 早期诊断

Abstract: Abstract Objective：To explore a new surgical method to treat hypertensive basal ganglia hemorrhage (HBGH) and its curative effect．Methods：A total of 21 patients with hypertensive cerebral hemorrhage in the fundus node at a super early stage (≤7h) were enrolled in this study．Microsurgery trough the lateral fissure and insula via pterional keyhole approach was employed to treat the patients．The CT reexamination within 2 days post-operation among all patients and they were evaluated by activities of daily living (ADL) after the operation 3-12 months．Results：The CT showed that hematoma clearance rate>90% was achieved in 18 cases，80~90% in 3 cases．All but one of the patients survived after the operation．The patients were evaluated by activities of daily living (ADL) after the operation． ADLⅠ was found in 4 cases，ADL Ⅱin 12 cases，ADL Ⅲ in 3 cases，ADL Ⅳ in 1 case and ADL Ⅴin 0 case． One case died． Conclusion：Super Early Stage Transsylvian Transinsular Approach on Hypertensive- Cerebral Hemorrhage in Basal Ganglia Regions had the advantages of short operating time，short pathway，minimal invasion and better patient recovery．It may improve in combination with comprehensive therapy．

Key words: hypertension, intracranial hemorrhage, hypertensive, basal ganglia hemorrhage, minimally invasive, early diagnosis