外侧裂入路显微手术治疗高血压丘脑出血

Microsurgery via lateral fissure approach for hypertensive thalamic hemorrhage (report of 49 cases)

目的探讨经外侧裂入路显微手术治疗高血压丘脑出血的效果并总结其临床经验。方法回顾性分析经外侧裂入路显微手术治疗的49例高血压丘脑出血患者的临床资料。结果术后24h内复查CT全部病例血肿清除满意,29例血肿清除100%,11例血肿清除90%以上,9例血肿清除80%以上。存活38例,死亡5例,放弃治疗6例。38例随访6个月～9年,按日常生活能力分级Ⅰ级12例,Ⅱ级14例,Ⅲ级9例,Ⅳ级3例。结论经外侧裂入路显微手术治疗高血压丘脑出血能够有效清除血肿,手术创伤小,术后并发症较少,治疗效果可靠,是治疗本病的有效手术方式之一。

Objectives To observe the curative effect of microsurgery via the lateral fissure on hypertensive thalamic hemorrhage （HTH）,and to summarize the clinical experience in treating HTH.Method The clinical data of 49 patients with HTH,who underwent microsurgery via the lateral fissure approach,were analyzed retrospectively.Results CT 24 hours after the operation showed that of 49 patients,29 received total evacuation of the hematoma,11 over 90% and 9 over 80%.Of 49 patients,38 survived,5 died and 6 gave up treatment.The following up from 6 months to 9 years showed that according to the activity daily living （ADL）,of 38 survivors,12 belonged in grade Ⅰ,14 in grade Ⅱ,9 in grade Ⅲ,3 in grade Ⅳ.Conclusion Microsurgery via the lateral fissure approach,which is of the merits includingminimal invasiveness,effective evacuation of the hematomas,fewer postoperative complications and good curative effect,is one of the effective surgical methods to treat HIH.