高血压基底节出血显微手术治疗临床分析

Clinical Analysis with Microsurgical Treatment in Patients with Hypertensive Basal Ganglia Hemorrhage

目的探讨高血压基底节出血的显微外科治疗技巧、效果和预后。方法回顾分析2007年3月-2009年10月52例高血压所致基底节出血患者的临床表现、影像学资料、手术方式、治疗效果及随访资料。结果 52例患者均于显微镜下清除血肿,无手术死亡。39例患者术后神经功能障碍得到改善,8例症状加重持续昏迷,5例术后1周死亡。术后随访6～18个月,35例生活基本能够自理[日常生活能力量表(ADL)Ⅰ～Ⅲ级],12例长期卧床(ADLⅣ级)。结论采用显微外科技术治疗高血压基底节出血效果良好。

Objective To investigate the technique,effectiveness,and prognosis of microsurgical treatment of hypertensive basal ganglia hemorrhage. Methods A retrospective study was carried out on 52 patients with hypertensive basal ganglia hemorrhage from March 2007 to October 2009. The clinical presentation,neuroradiological data,surgical approach,therapeutic efficacy and follow-up data were reviewed. Results All of the hematoma were removed under microscope without surgery-related death. After operation,the functional disorders of nervous system were improved in 39 patients. Eight patients deteriorated with persistent coma after operation,five patients died. The survivors were followed-up for six to 18 months. Thirty-five patients were able to self-care with some efforts （ ADL Ⅰ-Ⅲ） ,and 12 patients had hemiparalysis or coma （ ADL Ⅳ）. Conclusion Microsurgery is an effective treatment for hypertensive basal ganglia hemorrhage with microsurgical technique.