经侧裂-岛叶入路显微手术治疗高血压基底节区脑出血

Microsurgical treatment of hypertensive basal ganglia hematomas through transsylvian transinsular approach

目的探讨高血压基底节区脑出血的手术治疗方法和效果。方法对经侧裂-1叶入路显微手术治疗的58例高血压基底节区脑出血患者的临床资料进行回顾性分析。结果术后第l天复查头颅CT示：血肿清除〉90％者53例，其余5例血肿清除〈80％。术后存活50例，死亡8例。在存活的50例中，术后6个月根据GOS评分：恢复良好13例，中残18例，重残16例，植物生存2例，死亡1例。结论经侧裂-岛叶入路显微手术是治疗高血压基底节区脑出血较理想的方法，具有对脑组织损伤小、血肿清除率高、神经功能恢复好等优点。

Objective To study the method and effect of microsurgical treatment on patients with hypertensive basal ganglia hematomas through transsylvian transinsular approach. Method Fifty eight patients with hypertensive basal ganglia hematomas underwent microsurgical treatment through transsylvian transinsular approach and the clinical data were retrospectively analysed. Results The postoperative CT scan showed that 53 cases were removed the hematomas for more than 90% , while 5 cases less than 80%. Fifty patients survived and 8 patients died after operation. The therapeutic effects of the survival were evaluated at 6 months after operation according to Glasgow outcome scale （GOS） categories： good recovery, moderate disability, severe disability, persistent vegetative state and death were obtained in 13 cases, 18 cases, 16 cases, 2 cases and 1 case respectively. Conclusions Microsurgery through transsylvian transinsular approach is an effective treatment for hypertensive basal ganglia area hematomas, and it is characterized by minimal cerebral tissues injury, high hematomas removal ratio and good nervous function recovery.