翼点切口侧裂-岛叶入路治疗36例基底节脑出血的临床研究

目的 研究翼点切口侧裂-岛叶入路显微手术治疗基底节脑出血的临床疗效.方法 选取2009年7月～2013年7月收治的36例基底节脑出血患者为观察组,采用显微镜下翼点切口侧裂-岛叶入路手术治疗,另外随机选取同期进行常规开颅手术治疗的基底节脑出血患者30例为对照组,对比两组患者的治疗效果.结果 ①术后即刻CT及术后48小时CT复查,观察组血肿清除90％以上的患者31例,80％以上5例,手术成功率100％;对照组血肿清除90％以上的患者15例,80％以上6例,成功率70％.两组患者的术后血肿清除情况比较,观察组明显优于对照组,差异有统计学意义（P＜0.05）.②两组患者的ADL评分、恢复良好率、残疾率及死亡率对比,观察组均优于对照组,差异有统计学意义（P＜0.05）.结论 翼点切口侧裂-岛叶入路显微手术治疗基底节脑出血的血肿清除率高,手术成功率高,术后恢复良好率较高,创伤小,值得临床推广应用.

The clinical study on insular approach pterional incision in lateral fissure for treatment of basal ganglia hemorrhage

Objective To discuss the clinical effect of insular approach pterional incision in lateral fissure for treatment of basal ganglia hemorrhage.Methods 36 patients with basal ganglia hemorrhage were selected as the observation group.We used insular approach pterional incision in lateral fissure under microscope.We also randomly selected 30 cases of basal ganglia hemorrhage patients with conventional craniotomy treatment as the control group,the therapeutic effects were compared.Results There were 31 patients with 90% hematoma elimination,5 patients with above 80% he matoma elimination.The surgical success rate was 100%.In control group,there were 15 patients with 90% hematoma elimination,6 patients with above 80% hematoma elimination.The surgical success rate was 70%.The postoperative hematoma of observation group was significantly better than that of the control group （P〈0.05）.ADL scoring,the good recovery rates,the disability and death rates of the observation group was better than that the control group（P〈0.05）.Conclusion There are high hematoma elimination rate,surgical success rate and good recovery rate of insular approach pterional incision in lateral fissure under microscope to treat basal ganglia hemorrhage.