不同手术入路治疗高血压性基底节区脑出血的疗效观察

Treatment of hypertensive basal ganglia cerebral hemorrhage with different surgical approaches

回顾性分析2014年6月至2016年9月收治的60例基底节区高血压性脑出血患者的临床资料。根据血肿主体在颅骨、脑表面的相对位置，对血肿偏前、靠近侧裂前点者选择侧裂前点一脑岛入路36例，血肿偏后、远离侧裂前点者，选择下中央沟下点．脑岛入路11例、颞上沟一脑岛入路13例。术后随访6个月～1年，格拉斯哥昏迷评分法评分显示恢复良好14例，轻度残疾25例，重度残疾18例，植物状态1例，死亡2例。

According to the locations of main hematomas, 60 patients with hypertensive basal ganglia hemorrhage were surgically treated through different approaches from June 2014 to September 2017. Thirty six cases with anterior hematoma near the Sylvian point were treated through transsylvian-transinsular approach, 24 cases with the posterior hematoma far from the Sylvian point were treated through translower- rolandic-point （transLRP） transinsular approach （n = 11 ） or transsuperior-temporal-suleus （transSTS） transinsular approach （ n = 13 ）, respectively. All patients were followed up for at least 6 months and evaluated by Glasgow Outcome Scale. Fourteen patients showed good recovery, 25 patients showed moderate disability, 18 patients showed severe disability, one patients showed vegetative survival and two patients died.