显微镜下不同手术入路手术治疗高血压基底节区脑出血的临床对比研究

The clinical researchof treating hypertension basal ganglia region cerebral hemorrhage through lateral fissure of cerebrum region or Middle temporal gyrus under microscope

目的 观察显微镜下经侧裂入路与经颞叶皮层入路治疗60例高血压基底节区脑出血的临床效果.方法 回顾分析我院神经外科2010年1月～2011年1月行显微镜下经侧裂-岛叶入路治疗高血压基底节区脑出血患者60例,随即分为两组（A、B两组）,A组采用显微镜下经侧裂入路开颅血肿清除术、B组采用显微镜下经颞中回入路开颅血肿清除术.随访半年至1年,观察其格拉斯哥预后分级（GOS）.结果 A组患者中生存30例、死亡（GOS分级Ⅰ级）0例、植物生存（GOS分级Ⅱ级）3例、重残（GOS分级Ⅲ级）3例、中残（GOS分级Ⅳ级）15例、良好（GOS分级Ⅴ级）9例;B组患者中生存29例、死亡（GOS分级Ⅰ级）1例、植物生存（GOS分级Ⅱ级）3例、重残（GOS分级Ⅲ级）3例、中残（GOS分级Ⅳ级）20例、良好（GOS分级Ⅴ级）3例.结论 显微镜下经侧裂入路治疗高血压基底节区脑出血的临床效果可靠,手术创伤小,清除血肿彻底,是高血压基底节区脑出血首先手术方式.

Objective Observing the clinical research of treating 60 hypertension basal ganglia region cerebral hemor- rhage through lateral fissure of cerebrum region or middle temporal gyrus under microscope. Methods Retrospective analysis the 60 patients of hypertension basal ganglia region cerebral hemorrhage who were operated under microscope in our hospital between January 2010 and January 2011. these patients were randomly divided into two groups （A, B groups）, each group had 30 patients ;A group was operated through lateral fissure of cerebrum region under microscope, B group was operated through middle temporal gy- rus under microscope;Observing the GOS after six months to one year. Results . A group was followed up for six months to one year, observe its Glasgow prognostic classification （GOS） ; Survival in 30 patients with 30 cases, 0 case death （ GOS score 1 point） ,3 cases plant survival （ GOS score 2） , 3 cases severe disabilities （ GOS score 3 points）, 15 cases incomplete （ GOS score 4 ） , 9 patients were good （ GOS score 5 points）. B group was followed up for six months to one year, observe its Glasgow prognos- tic classification （GOS） ; Survival in 29 patients with 30 cases, 1 case death （GOS score 1 point）, 3 cases plant survival （GOS score 2） , 3 cases severe disabilities （ GOS score 3 points）, 20 cases incomplete （ GOS score 4）, 9 patients were good （ GOS score 5 points）. Conclusion The clinical effect of treating 60 hypertension basal ganglia region cerebral hemorrhage through lat- eral fissure of cerebrum region under microscope was reliable, which is an effective surgical procedure treating hypertension basal ganglia region cerebral hemorrhage.