显微手术外侧裂入路治疗高血压丘脑出血

Microsurgical treatment via lateral fissure approach for hypertensive thalamic hemorrhage

目的观察显微手术外侧裂入路显微手术治疗高血压性丘脑出血的疗效。方法对36例高血压性丘脑出血采用经外侧裂入路小骨窗开颅或去骨瓣减压开颅,显微镜下清除血肿。结果全部病例血肿清除满意,术后24h内复查了解血肿清除情况,23例血肿清除100%,6例血肿清除90%以上,7例血肿清除80%以上。结论外侧裂入路显微手术创伤小,止血可靠,能有效降低颅内压,是治疗高血压性基底节区出血的有效手术方式之一。

Objective To study the clinical effect of microsurgery via lateral fissure treating hypertensive thalamic hemorrhage,and summarize the clinical experience. Methods Craniotomy with small bone flap via lateral fissure or/and decompressive craniectomy were applied to evacuate hematoma originating from hypertensive thalamic hemorrhage,36 cases were analyzed retrospectively. Results The effect of this method was satisfactory. Total evacuation was achieved in 23 cases（93.9%）, hematoma was removed over 90% in 6 cases and over 80% in 7 cases. Conclusion Microsurgical treatment via lateral fissure approach has the advantage of minal invasion,good operational field exposure and less impairment on normal brain tissue by manipulation through normal anatomical spaces and unimportant domain. It possesses the merits of finding bleeding part quickly,performing hemostasis effectively, reducing secondary bleeding and evacuating hematoma thoroughly,and it is one of the effective methods for hypertensive thalamic hemorrhage.