微创小骨窗开颅手术治疗高血压脑出血的疗效观察

Effect of Microsurgery through Small Skull Window on Hypertensive Intracerebral Hemorrhage

目的探讨小骨窗微创治疗高血压脑出血的疗效。方法在全身麻醉状态下,对40例高血压脑出血患者采用直径<4 cm的小骨窗微创治疗,依据日常生活能力(ADL)分级法判定疗效。结果 40例患者均顺利完成手术,术后随访3～12个月,采用ADL分级法:Ⅰ级4例,Ⅱ级12例,Ⅲ级14例,Ⅳ级6例,Ⅴ级2例,死亡2例。结论微创小骨窗开颅手术治疗高血压脑出血与传统大骨瓣开颅手术比较具有对脑组织损伤小、手术时间短等优点,是较为理想的治疗方法,尤其适用于基层医院。

Objective To explore the effect of minimally invasive surgery via small skull window on hypertensive cerebral hemorrhage in basal ganglia region. Methods 40 patients with hypertension intraeerebral hemorrhage （HIH） were operated with minimally invasive surgery via a 4 cm-diameter small bone window under general anesthesia. The effect was evaluated by ADL scale. Results During 3 - 12 months of follow-up, the amount of patients in Level I, II, IIl, IV and V were 4, 12,14,6 and 2, respectively expect 2 dead patients. Conclusion Compared with traditional skull operation, microsurgery through small skull window has minor damage, clearer operation field, shorter operation time and better hemostatic effect. It＇ s a relatively ideal treatment for hypertension cerebral hemorrhage and can be used in the neurosurgery department of primary hospitals.