经翼点入路显微手术治疗基底节脑出血

Pterional approach microsurgery for intracerebral hemorrhage in basal ganglia

目的 探讨经翼点入路显微手术治疗基底节脑出血的手术要点及疗效。方法 对27例经CT检查证实的基底节区脑出血，血肿量为50—100ml，部分病例血肿经额角破入脑室铸型，行经翼点入路显微手术治疗，术后给予呼吸机治疗。结果 27例患者中20例术后立即复查CT，7例48h复查CT，血肿清除率95％以上26例，1例术后再出血40ml，并再次开颅手术，术后6个月日常生活能力（ADL）恢复良好14例。结论 经翼点入路显微手术创伤小、手术显露满意，清除血肿彻底，止血可靠，能有效降低颅内压，是高血压脑出血的有效手术方式之一。

Objective To explore the operational highlight and efficacy of pterional approach microsurgery in treatment of intracerebral hemorrhage in basal ganglia.Method From Apr 1998 to Jan 2005,27 basal ganglion hemorrhage cases confirmed by CT scan with hemorrhage volume 50- 70 ml, some cases with hemorrhage into ventricle through frontal horn, were treated with pterional approach microsurgery and respirator therapy postoperatively. Results Twenty cases received CT scan immediately after operation and 7 cases received CT scan 48 hours after operation. The hemorrhage clearance rate was over 95 % in 26 cases. One case had 40 ml rehemon-hage and underwent second operation. Fourteen cases had ADL good outcome. Conclusions Pterional approach microsurgery has the advantage of minimal invasion, good operational field exposure, thorough hemorrhage clearance, reliable hemostasis and decreasing intmcranial pressure effectively. Especially it can be used conveniently to evacuate the hemorrage into ventricle through frontal horn. Pterional approach microsurgery is one of the effective methods for hypertensive intracerebral hemorrhage.