摘要
目的探讨小骨窗开颅微创治疗基底节高血压脑出血的临床疗效。方法对138例基底节区高血压脑出血患者采用小骨窗开颅,显微镜下清除血肿。结果术后24h内复查CT显示,117例血肿清除90%以上,21例血肿清除80%以上。死亡13例,其中5例死于术后再出血所致的脑疝,3例死于肺部感染,2例死于多器官衰竭,死于颅内感染、气道梗阻及消化道大出血各1例。术后生存125例,平均随访8(3~12)个月,日常生活能力(ADL)分级:Ⅰ级25例,Ⅱ级49例,Ⅲ级34例,Ⅳ级15例,Ⅴ级2例。结论小骨窗开颅显微手术创伤小,术野显露充分,血肿清除彻底,止血可靠,是治疗基底节高血压脑出血的有效手术方式之一。
Objective To explore the effectiveness of mini-invasive surgery for hypertensive basal ganglia hemorrhage by small skull-window craniotomy.Method All the 138 patients of hypertensive basal ganglia hemorrhage were performed the small skull-window craniotomy and hematoma clearance under microscope.Results The CT reexamination showed that hematoma was removed over 90% in 117 cases and over 80% in 21 cases within 24 hours after the operation.A total of 13 patients died,including 5 died of cerebral hernia associated with rehaemorrhagia,3 of pulmonary infection,2 of multiple organ failure,1 of intracranial infection,1 of airway obstruction and 1 of massive hemorrhage of gastrointestinal tract.125 cases survived and were followed up for 3 to 12 months with an average of 8 months.According to the activities of daily living(ADL) scale,the outcomes revealed that grade Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ were 25,49,34,15 and 2 cases respectively.Conclusion Microsurgery via small skull-window craniotomy is one of the effective methods for hypertensive basal ganglia hemorrhage with the advantages of minimal invasion,sufficient operation field exposure,exhaustive clearance of hematoma and reliable hemostasis effect.
出处
《中国现代手术学杂志》
2010年第4期289-292,共4页
Chinese Journal of Modern Operative Surgery
关键词
颅内出血
高血压性
显微外科手术
intracranial hemorrhage
hypertensive
microsurgery