小骨窗经侧裂-岛叶入路显微手术治疗基底节高血压脑出血36例临床分析

目的探讨小骨窗经侧裂．岛叶入路显微手术治疗基底节高血压脑出血的手术方法和疗效。方法对36例基底节区高血压脑出血采取经侧裂一岛叶入路显微手术清除血肿，并与同期34例行传统骨瓣开颅患者的临床疗效进行对比。结果2组手术时间、术后并发症、术后清醒时间方面差异有统计学意义（P〈0．05），小骨窗经侧裂组术后恢复良率（ADLⅠ-Ⅲ级）明显高于骨瓣组（P〈0．05），两者血肿清除率及痛死率比较差异无统计学意义（P〉0．05）。结论小骨窗经侧裂．岛叶入路显微手术治疗基底节高血压脑出血具有创伤轻，手术显露满意，血肿清除彻底，止血可靠，术后神经功能恢复好，致残、致死率低等优点。

Clinical analysis for the therapeutic effect of micro-surgery with small bone flap via transsylvian fissure-insular approach on hypertensive hemorrhage of basal ganglia region in 36 patients

Objective To investigate the therapeutic effect and operation method of micro-surgery with small bone flap via transsylvian fissure-insular approach on hypertensive hemorrhage of basal ganglia region. Methods 36 patients with HBGH received the micro-surgery via transsylvian fissure-insular approach to remove the hematoma, and the therapeutic effects were compared with those of routine craniotomy via large bone flap in 34 patients. Results There was a significant difference in operation time, complications and awakening time after operation between the two groups（P 〈 0.05 ）. The recovery rates （ ADL Ⅰ -Ⅲ ） in small bone flap treatment group were significantly higher than those of large bone flap treatment group（ P 〈 0.05）. There were no significant differences in clearance rate of hematoma and patients＇ mortality between two groups （ P 〉 0.05 ）. Conclusion Micro-surgery treatment via transsylvian fissure-insular approach for hypertensive hemorrhage of basal ganglia region is a kind of minimally invasive method with little injury, good exposure, complete hematoma removing, reliable stopping the blood flow, favorable recovery of neural function and low mortality.