颞下岩前入路治疗桥脑出血疗效分析

Efficacy of surgical treatment for pontine hemorrhage via infratemporal-prepetrosal approach

回顾性分析2013年1月至2021年6月期间苏州大学附属第一医院神经外科收治并通过颞下岩前入路进行手术治疗的20例桥脑出血患者临床资料。男15例,女5例;年龄32~69岁,平均年龄47.9岁。病程3.5~16.0 h,平均6.7 h。均完成手术治疗,其中血肿完全清除17例,部分清除3例。术后30 d随访,死亡1例,死于多器官功能障碍综合征;其余患者术后90 d随访,格拉斯哥预后量表(GOS)评分5分1例,4分7例,3分6例,2分4例,1分2例。颞下岩前入路治疗桥脑出血属于安全、合理、可行的治疗方案。尤其对于年龄<50岁,术前格拉斯哥昏迷量表(GCS)评分较高并且具备手术指征的患者,颞下岩前入路能够有效降低病死率,改善桥脑出血预后,并且应当尽快在出血后6 h内进行手术。

Herein,the clinical data of 20 patients with pontine hemorrhage were retrospectively analyzed.All the patients underwent surgery via infratemporal-prepetrosal approach between January 2013 and June 2021 in the Department of Neurosurgery from the First Affiliated Hospital of Soochow University.There were 15 males and 5 females.The age ranged from 32 to 69 years,with an average age of 47.9 years.The course of disease was 3.5-16.0 h,with an average of 6.7 h.All the patients underwent surgery successfully.The hematomas of 17 patients were completely removed while the hematomas of the other 3 patients were partially removed.One patient died of multiple organ dysfunction syndrome during 30 days follow-up after surgery.The other patients were evaluated by Glasgow outcome scale(GOS),and the results showed that 1 patient was in Grade 5,7 patients were in Grade 4,6 patients were in Grade 3,4 patients were in Grade 2,and 2 patients were in Grade 1.The surgery via infratemporal-prepetrosal approach is a safe,reasonable and feasible treatment for pontine hemorrhage.Especially for the patients who were younger than 50 years old,with high preoperative Glasgow Coma Scale(GCS)grade and surgical indications.This surgical technique can effectively reduce the mortality and improve the prognosis of patients with pontine hemorrhage.Moreover,patients should be operated within 6 hours after pontine hemorrhage as soon as possible.