超早期小骨窗经侧裂入路显微手术治疗高血压基底节脑出血

目的：探讨超早期小骨窗经侧裂入路治疗高血压基底节脑出血的疗效。方法：回顾性分析2003年1月～2005年6月超早期应用小骨窗经侧裂入路显微手术治疗的27例病例的资料。结果：所有病例在术后24h内均行头颅CT检查以了解血肿清除情况，24例血肿清除80％以上，3例血肿清除在70%以上，1例术后10h出现再出血，随访6个月时ADL恢复良好率为74．1％，死亡率为11．1％。结论：超早期小骨窗经侧裂入路治疗高血压基底节脑出血能有效地减轻颅内占位效应，减少脑继发性损害，促进神经功能恢复，致残、致死率低是一种疗效优、损伤轻、预后好的治疗方法。

Ultra-early Microsurgery with Small Bone Flap Craniotomy and Lateral Fissure Approach in the Treatment of Hypertensive Hemorrhage of Basal Ganglia Region

Objective:To explore the effectiveness of microsurgery through lateral fissure approach for treating hypertensive hemorrhage of basal ganglia region.Methods:The surgical data of microsurgery through lateral fissure approach for 27 cases were retrospectively analyzed from January 2003 to June 2005 in our hospital.Results:The CT re-examination within postoper- ative 24 hours showed that the hematoma was removed by over 80% in 24 cases and 70% in 3 cases.However,one case had rebleeding 10 hours after operation.After 6 months follow-up,the good ADL ration was 74.1% and the mortality was 11.1%.Conclusion:Ultra-early microsurgery through lateral fissure approach is a kind of minimally invasive method for trea- ting hypertensive hemorrhage of basal ganglia region with little secondary brain damage,desirable effect of decompressing the mass effect and favorable recovery of neurological function as well as low morbidity and mortality.