小骨窗经侧裂-岛叶入路手术治疗高血压脑出血

Efficacy of minimally invasive surgical treatment via transsylvian fissure-insular approach for hypertensive intracranial hemorrhage

目的分析小骨窗经侧裂-岛叶入路手术治疗高血压脑出血的效果。方法应用小骨窗经侧裂-岛叶入路手术治疗高血压脑出血36例,并与38例接受常规骨瓣皮质造瘘手术患者进行比较。结果与接受常规的骨瓣皮质造瘘入路手术者相比,接受小骨窗经侧裂-岛叶入路手术者的术后并发症率明显下降(分别为47.4%和25.0%,P<0.05)、术后6月的良好恢复率高[手术后6月格拉斯哥结局量表(GOS)分别为55.3%和77.8%,P<0.05]。结论小骨窗经侧裂-岛叶入路手术治疗高血压脑出血的近期和远期疗效优于常规手术。

Objective To observe the efficacy of minimally invasive surgery via transsylvian fissure-insular approach in patients with hypertensive intracranial hemorrhage . Methods Thirty-six patients were treated by minimally invasive neurosurgery for hematoma evacuation via transsylvian fissure-insular approach ,and their outcomes were compared with those of 38 patients treated by with routine surgery for hematoma evacuation . Results Compared with the patients treated by routine hematoma evacuation surgery , patients treated with minimally invasive surgery had less post-operation complications ( 47.4% vs 25.0%, P<0.05 ) and higher rate of favorable outcome assessed by Glasgow Outcome Scale (GOS) 6 months after surgery (55.3% vs 77.8%,P<0.05). Conclusion The recent and remote efficacies of minimally invasive neurosurgery for hematoma evacuation via transsylvian fissure -insular approach for hypertensive intracranial hemorrhage are better than that by routine hematoma evacuation surgery .