水分离技术在治疗高血压脑出血中的应用

Application of water jet dissection technique in the treatment of hypertensive cerebral hemorrhage

目的探讨水分离技术在经侧裂-岛叶手术治疗基底节区高血压脑出血中的应用及效果。方法对42例应用水分离技术经侧裂-岛叶入路显微手术治疗的基底节区高血压脑出血患者的临床资料进行回顾性分析。结果 42例患者均术后24 h内行CT扫描,38例血肿清除完全,4例血肿少量残留,术后存活40例,死亡2例。存活40例患者均随访3月以上,ADL评分为I级13例,Ⅱ级15例,Ⅲ级9例,IV级2例,V级1例。结论水分离技术是一种安全简便的分离技术,在经侧裂-岛叶清除基底节区高血压脑出血中能很好帮助解剖侧裂和清除血肿,且对脑组织损伤小、血肿清除彻底、神经功能恢复好。

Objective To study the application and effect of water jet dissection technique in microsurgical treatn^nt of hypertensive cerebral hemorrhage via transsylvian transinsular approach. Methods The clinical data of 42 patients with hypertensive cerebral hemorrhage in the basal ganglia who accepted microsurgical treament via transsylvian transinsular approach by water jet dissection technique were analyzed retrospectively. Results Post- operative CT within 24 h was performed in 42 cases, which showed that the henmomas were evacuated totally in 38 cases and a small amount of residual in 4 cases. Forty cases survived and 2 cases died after operation. All 40 survived cases were followed up for more than 3 months. According to the activity of daily living, there were 13 cases of grade I, 15 cases of grade I1, 9 cases of grade III, 2 cases of grade IV, and 1 case of grade V. Conclusion The water jet dissection technique can be applied very simply and safely, which is effective for opening the sylvian fissure and removing hematoma on hypertensive cerebral hemorrhage in the basal ganglia via transsylvian transinsular approach, which it is characterized by minimal cerebral injury, high removal rate and good function recovery.