经侧裂岛叶入路治疗基底节区脑出血分析

目的:分析经侧裂岛叶入路治疗基底节区脑出血的临床效果。方法:32例基底节脑出血患者,20例行去大骨瓣侧裂岛叶入路血肿清除术(去大骨瓣组),12例行微骨窗侧裂岛叶入路血肿清除术(微骨窗组)。结果:去大骨瓣组72 h内清醒者10例,3～7 d清醒者6例,7～14 d清醒者4例;微骨窗组均于72 h内清醒;术后随访6～11个月,去大骨瓣组轻度残疾7例,重度残疾13例;微骨窗组轻度残疾7例,重度残疾5例。结论:经侧裂岛叶入路治疗基底节区血肿是一个较佳选择,对于术前意识状态相对较好的患者,微骨窗入路微创,术后清醒早,且避免了二次颅骨修补手术。

Surgical treatment of basal ganglia haematoma through transsylvian-insular approach

Objective：To investigate the clinical effects of Surgical treatment of basal ganglia haematoma through transsylvian-insular approach.Methods：A total of 32 patients with basal ganglia haematoma were all treated by surgery.Removal of bone flap by transsylvian-insula approach（Bone flap removal group） was applied on 20 cases,and surgery by transsylvian-insula approach to remove the haemotoma was performed on other 12 cases（Micro-hole group）.Results：In the bone flap removal group,10 patients resumed normal consciousness within 72 h after the surgery,6 and 4 cases resumed between 3-7 and 7-14 days after the surgery,respectively;while all patients resumed normal consciousness with 72 h after surgery.According to follow up conducted for 6-11 months,7 patients were mild disabled and 13 got sever disability;the corresponding numbers of patients were 7 and 5 in the micro hole group.Conclusions：Surgical treatment by transsylvian-insula approach to remove the haemotoma is an optimum option for basal ganglia haematoma,for patients with consciousness;microsurgery should be adopted since it can help patients to resume clear consciousness soon and avoid risks of a second skull repair surgery.