幕上高血压脑内血肿锁孔微创手术治疗

目的探讨高血压脑内血肿显微外科微创治疗的优越性。方法对57例中量和大量幕上高血压性脑内血肿的患者,采用经颅锁孔、经脑池(或皮层)小切口显微微创血肿清除术。结果本组死亡5例,植物生存7例,严重失能11例,中度失能20例,良好14例;其中死亡5例的直接致死性原因均为合并有多脏器功能严重衰竭。结论采用经颅锁孔、经脑池(或皮层)小切口显微微创血肿清除术可以做到有效的血肿清除、良好的腔内止血、满意的颅内减压、微小的手术创伤,从而达到疗效/损伤比的最大化。同时该术式的直接效果还取决于术者的技术水准。

Minimally invasive surgery for supratentorial hypertensive intracerebral hematoma by keyholl

Objective To study the advantages of microsurgical treatment with minimal trauma for hypertensive intracerebral hemorrhage at supratentorium. Methods Fifty-seven cases of supratentorial hypertensive intracerebral hematoma of moderate and large amount were treated with hematoma removal microsurgically via keyhole and a small incision of cistern or cortex. Results Of the 57 cases, 5 died, 7 survived in vegetative state, 11 in severe dysfunction, 20 in moderate dysfunction, 14 in good recovery. The cause of all dead cases was multiple organs failure. Conclusion Microsurgical removal of supratentorial hypertensive intracerebral hematoma via keyhole and a small incision of cistern or cortex can effectively remove the hematoma, decompress the intracerebral pressure, and increase the operative trauma to the minimum, so that the ratio of efficacy to trauma gets to the maximum. But the direct outcome of surgery is also related to the skills of operator.