超早期小骨窗经外侧裂-岛叶入路手术治疗基底节区高血压脑出血

Treatment of hypertensive intracerebral hemorrhage of basal ganglia with ultra-early small bone window via sylvian fissure-insula approach

目的探讨超早期小骨窗经外侧裂-岛叶入路手术治疗基底节区高血压脑出血的疗效。方法回顾性分析48例经超早期小骨窗外侧裂-岛叶入路手术治疗的基底节区高血压脑出血患者临床资料。结果 48例中,血肿完全清除43例(90%),血肿大部分清除5例(10%)。随访6-12个月,按照日常生活活动能力(ADL)分级评估:存活45例,其中Ⅰ级8例(16.66%),Ⅱ级13例(27.08%),Ⅲ级15例(31.25%),Ⅳ级6例(12.50%),Ⅴ级3例(6.25%);死亡3例(6.25%)。结论超早期小骨窗经外侧裂-岛叶入路手术治疗高血压脑出血对脑组织及血管损伤小,能有效的清除血肿,改善神经功能。

Objective To study the outcomes of treating hypertensive intracerebral hemorrhage （HICH） of basal ganglia with ultra-early small bone window via sylvian fissure-insula approach. Methods The clinical data of 48 patients with HICH treated by ultra-early small bone window through sylvian fissure-insula approach were analyzed retrospectively. Results CT examinations within 24 hours after operation showed that the hematomas were totally clearned out in 43 patients （90%）, and hematomas were mostly clearned out in 5 patients（ 10 %）. Of 45 patients followed-up for 3 months to 1 year, 8 cases were assigned in grade I , 13 in grade Ⅱ , 15 in grade Ⅲ, 6 in grade Ⅳ and 3 in grade Ⅴ according to activities of daily living（ADL）. Three cases died. Conclusion Ultra-early small bone window through sylvian fissure-insula approach for surgical treatment of basal ganglia of HICH can effectively clearn out the hematoma with less damage of braintissues and blood vessels,and promote neurological recovery.