经外侧裂入路显微手术治疗基底节区脑出血

Transsylvian fissure micro operation in treatment of cerebral hemorrhage in basal ganglia

目的观察经外侧裂入路显微手术治疗基底节区脑出血的临床疗效。方法选择2010年1月~2013年1月该院40例经外侧裂入路显微手术治疗的基底节区脑出血患者,设为观察组,同时选择40例经颞叶皮层入路治疗的基底节区脑出血患者,设为对照组。观察术后24-48 h颅内血肿清除程度与半年后日常生活活动能力（ADL）评分。结果观察组术后24-48 h,血肿清除程度〈60%、60%-80%、〉80%比例为52.5%、32.5%和15.0%,对照组为30.0%、20.0%及50.0%,其中观察组血肿清除程度〉80%比例明显多于对照组,差异有统计学意义（P〈0.05）。随访半年,ADL分级显示,观察组恢复良好者（ADL1-2级）比例为67.5%,明显大于对照组的35.0%,差异有统计学意义（P〈0.05）。结论经外侧裂入路显微手术治疗基底节区脑出血,疗效可靠,对脑血管、脑组织等损伤较小,能够促进术后患者恢复及提高生活质量。

【Objective】 To observe the clinical effect of lateral fissure approach microsurgical operation in treatment of cerebral hemorrhage in basal ganglia. 【Methods】 A retrospective analysis of 40 cases of ranssylvian microsurgical operation in patients with cerebral hemorrhage in basal ganglia region in our hospital January from 2010 to January 2013 in our hospital, as the observation group, while 40 cases of the temporal cortex in patients with cerebral hemorrhage in basal ganglia, as control group. Postoperative 24 to 48 h clearance degree of hematoma and activities of daily living（ADL） score. 【Results】 The patients in the observation group 24 to 48 h（view）, hematoma clearance level 60%, 60% - 80%, 〉80%, the ratio were 52.5%, 32.5%, 15%, respectively, in the control group were 30%, 20%, 50%, and the observation group clearance degree 80% was significantly more than the control group, there was significant difference（P〈0.05）. Followed up for half a year, ADL grading showed, the observation group（ADL 1 - 2） proportion of good recovery was 67.5%, obviously higher than that of control group was 35%, there was significant difference（P〈0.05）. 【Conclusion】 Transsylvian fissure microsurgery operation in treatment of basal ganglia intracerebral hemorrhage is reliable, cerebrovascular and brain damage are less, to improve the postoperative recovery of patients, and improve the quality of life.