内窥镜辅助经外侧裂-岛叶入路显微外科手术治疗基底节区高血压脑出血研究

Endoscope assisted microsurgery treatment via transsylvian fissure-inscular approach for intracerebral hematoma in basal ganglia region

目的探讨使用神经内窥镜辅助下经外侧裂-岛叶入路显微外科手术治疗基底节区高血压脑出血的疗效。方法回顾分析2008年1月～2011年12月我院12例高血压基底节区脑内血肿患者的资料,患者均在急性期接受神经内窥镜辅助下经外侧裂-岛叶入路显微手术治疗。结果术后即刻复查CT示9例血肿基本清除,3例清除约80%,其中2例出现了术后少量迟发出血,均保守治疗成功。随访6个月时GOS评分:恢复良好8例,轻度残疾2例,重度残疾2例,无植物生存及死亡病例。结论经外侧裂-岛叶入路显微外科手术治疗基底节区高血压脑出血具有微创的特点,内窥镜辅助下能有效清除脑内血肿,并减少了颞叶皮层及血管的损伤,有益于改善患者的预后。

Objective To study the therapeutic effects for cerebral hematomas in basal ganglia region by endoscope as- sisted microsurgery via transsylvian fissure-insular approach. Methods Retrospective analysis 12 cases which performed en- doscope assisted microsurgery via transsylvian fissure-inscular approach for intracerebral hematoma in basal ganglia region in a- cute stage. Results The CT scan after surgery showed the hematomas almost removed in 9 cases, 80% removed in 3 eases. The GOS after follow-up for 6 months： good outcome was achieved in 8 cases, mild disability in 2 cases, severe disability in 2 cases, no patient died after surgery. Conclusion Endoscope assisted microsurgery treatment via transsylvian fissure-inscular approach for intracerebral hematoma in basal ganglia region is minimal invasive and effective, reduce the damage of cortex of temporal lobe and vessels.