高血压性基底节区脑出血的显微手术治疗

Microneurosurgery for Hypertensive Intracerebral Hemorrhage in Basal Ganglia Region

目的探讨经侧裂-岛叶入路显微手术治疗高血压性基底节区脑出血的效果。方法 2008年8月～2012年8月对25例高血压性基底节区脑出血在显微镜下分离外侧裂,经岛叶无血管区进入血肿腔,行血肿清除术。术后按照严格的内科治疗,控制血压,神经营养,康复治疗,进行ADL评分。结果术后存活24例,死亡1例(4.0%)。24例术后3个月按ADL评分:Ⅱ级13例(54.2%),Ⅲ级8例(33.3%),Ⅳ级2例(8.3%),Ⅴ级1例(4.2%)。结论经侧裂-岛叶入路显微手术治疗高血压性基底节区脑出血创伤小,疗效满意。

Objective To evaluate the curative effects of hypertensive intracerebral hemorrhage in basal ganglia region treated by microneurosurgery through lateral fissure-insular lobe approach. Methods A total of 25 cases of hypertensive intracerebral hemorrhage in basal ganglia region were respectively treated by microneurosurgery through lateral fissure-insular lobe approach from August 2008 to August 2012. We separated lateral fissure, and then performed evacuation of hematoma through avascular area in insular lobe under microscope. Patients received postoperative medical treatment, including blood pressure control, neurotrophy and rehabilitation treatment. Activities of daily living （ADL） was used for assessment. Results Twenty four patients survived the surgery, and one died（4.0% ）. All the 24 cases were assessed by ADL： 13 cases （54.2%） were grade Ⅱ , 8 cases （33.3 % ） grade Ⅲ , 2 cases （8.3%） grade Ⅳ and 1 case （4.2%） grade Ⅴ. Conclusion Microneurosurgery through lateral fissure-insular lobe approach is minimally invasive and clinically effective for treating patients with hypertensive intracerebral hemorrhage in basal ganglia region.