小骨窗经侧裂岛叶显微镜及内窥镜下清除高血压基底节区血肿

ELIMINATION OF HYPERTENSIVE PUTAMINAL HEMATOMAS THROUGH SMALL BONE-WINDOW TRANSSYLVIAN TRANSINSULAR APPROACH WITH THE HELP OF MICROSCOPE AND NEUROENDOSCOPE

[目的]探讨和研究小骨窗经侧裂岛叶入路显微镜及内窥镜辅助下清除高血压性基底节区血肿的手术方法。[方法]选取高血压性基底节区血肿25例病人,出血6h内全麻下行颞部直切口小骨窗经侧裂岛叶入路显微镜及及内窥镜辅助下行血肿清除手术。[结果]术后24h内复查CT血肿清除率均在90%以上,所有病例在7d内GCS到达13分以上,术后10月随访,GOS优9例,中残13例,重残3例,无植物生存状态病例。[结论]小骨窗经侧裂岛叶显微镜及内窥镜下清除高血压基底节区血肿,有利于保护和促进神经功能恢复。

[Objective] To discuss the surgical treatment of hypertensive putaminal hematomas through small bone-window transsylvian transinsular approach with the help of microscope and neuroendoscope. [Methods] Retrospectively studied 25 cases of hypertensive putaminal hematomas through small bone-window transsylvian transinsular approach with the help of microscope and neuroendoscope in 6 hours. [Results] Reexamined the CT in 24 hours after operation, hematoma clearance rate was above 90%, all cases＇ GCS arrived at above 13 points in 7 days after the operation; 10 months after the operation, follow-up was carried out. 9 examples＇ GOS superior, medium disability 13, heavy disability 3 examples, non-plant survival condition case. [Conclusion] The surgical treatment of hypertensive putaminal hematomas through small bone-window transsylvian transinsular approach with the help of microscope and neuroendoscope may eliminate the hematomas safely and effectively, stop bleeding precisely, make wound smaller, and is advantageous to the protection and the promotion of nerve function restoration.