小骨窗开颅显微手术治疗高血压幕上脑出血

Microsurgical Treatment of Hypertensive Supratentorial Intracerebral Hemorrhage by Small Craniotomy

目的 :探讨小骨窗开颅显微手术治疗高血压幕上脑出血的临床效果。方法 :对出血量超过35mL或合并脑疝的高血压幕上脑出血患者 1 5 8例 ,行小骨窗开颅显微镜下清除血肿。结果 :病死 2 7例 ,病死率 1 7.0 8%。临床生存 1 31亡例 ( 82 .92 %) ,其中恢复良好 46例 ( 2 9%) ,中残 63例 ( 39.7%%) ,重残2 0例 ( 1 3%) ,植物生存 2例 ( 1 .3%)。结论 :小骨窗开颅显微手术治疗高血压幕上脑出血直视下清除血肿的同时还可彻底止血 ,具有创伤小。

Objective:To discuss microsurgical treatment of hypertensive suprotentorial intracerebral hemorrhage by small craniotomy. Methods:158 cases of patient with the hematoma volume of 35 milli litre or more or cerebral herniation were operated macroscopically by small craniotomy. Results:27 died, mortality17.08%,clinical survival were 131(82.92%),recovered 46(29%), moderately disabled 63(39.7%),severely disabled 20(13%),persistently vegetative 2(1.3%). Conclusions:Microsurgery by small craniotomy approach for hypertensive supratentorial intracerebral hemorrhage results in improved outcome as to others of treatment and characterized by its minimal invasiveness, complete hemostasis, and safety.