去骨瓣减压术在重症高血压基底节区脑出血早期治疗中的应用探讨

Application Study of Decompressive Craniotomy at Early Stage Treatment on Hypertensive Hemorrhage in Basal Ganglia Region

目的:探讨重症高血压基底节区脑出血病人早期的手术治疗方法及治疗效果。方法:62例重症高血压基底节区脑出血病人均采用翼点入路,额颞部骨瓣开颅,大小约10cm×8cm,显微镜下经颞中回到岛叶,清除血肿。术后均去除骨瓣。结果:患者幸存60例,死亡2例。随访6月,按日常生活活动分级,Ⅱ级30例,Ⅲ级18例,Ⅳ级10例,Ⅴ级2例。结论:去骨瓣减压显微镜下清除血肿是治疗重症高血压基底节区脑出血的良好方法,能有效降低颅内压,改善预后。

Objective To explore the surgical skills and the curative effect of micro neurosurgery on severe hypertensive hemorrhagein in basal ganglia region. Methods 62 patients with severe hypertensive hemorrhagein in basal ganglia regions were operated. Through extended Pterional Approach the fronto tempory craniotomy were performed in all the patients. The center of cranial bone window which covered an area of 10cm x8 cm. the hematomas were removed by micro neurosurgery through the middle temporal gyrus and insular lobe in all the patients. The cranial bones were removed in all patients during the operation. Results 60 survived and 2 died in patients after operation. Of survivors who were followed up from 6 months, 30 belonged in grade I, 18 in grade III, 10 in grade IV , 2 in grade V according to activities of daily living. Conclusions ed Pterional Approach the fronto tempory craniotomy good method to treat severe hypertensive hemorrhagein Through extend for the hematomas and decompressive craniotomy is a in basal ganglia region, may be improve the prognoses in the patients with severe hypertensive hemorrhagein in basal ganglia region.