显微手术治疗急性期高血压性基底节区脑出血的疗效

Efficacy of Microsurgery in the Treatment of Hypertensive Basal Ganglia Hemorrhage in Acute Stage

目的:探讨显微手术治疗急性期高血压性基底节区脑出血的疗效。方法:回顾分析2008年1月-2010年12月行显微手术治疗的26例急性期高血压性基底节区脑出血患者的临床资料。26例均以术中超声和神经内镜定位,经颞叶前部皮层造瘘或经侧裂岛叶入路清除颅内血肿。采用Barthel指数分级法对患者日常生活能力(activities of daily living,ADL)进行评定。结果:26例患者血肿清除均顺利,其中2例因进行性中枢神经系统功能衰竭而病死;2例因肺部感染病死;其余22例ADL评定结果为Ⅰ级2例,Ⅱ级2例,Ⅲ级10例,Ⅳ级5例,Ⅴ级3例。结论:采用显微手术治疗急性期高血压性基底节区脑出血具有损伤轻、疗效优、预后好的优点。

Objective：To explore the therapeutic effects of microsurgery on hypertensive basal ganglia hemorrhage in acute stage.Methods：From January 2008 to December 2010,26 patients with hypertensive basal ganglia hemorrhage in acute stage were selected,whose intracranial hematoma were removed via transtemporal-cortical or transsylvian-insular approach assisted by intraoperative orientation under ultrasonography and neuroendoscopy.The patients＇ activities of daily living（ADL） were evaluated by Barthel index.Results：All the 26 patients obtained satisfactory hematoma evacuation.Among the 26 cases,2 patients died of progressive central nervous system failure,while another 2 patients died of pulmonary infection.The ADL grading results of the other 22 patients were Grade Ⅰ in 2 cases,Grade Ⅱ in 2 cases,Grade Ⅲ in 10 cases,Grade Ⅳ in 5 cases,Grade Ⅴ in 3 cases.Conclusions：Microsurgical treatment for hypertensive basal ganglia hemorrhage in acute stage has the advantages of less damage,better therapeutic effect and more favorable prognosis.