中少量高血压基底节区出血显微手术治疗

目的探讨经侧裂-岛叶入路显微手术治疗中少量高血压基底节区出血的疗效。方法回顾性分析62例出血量在20～30ml、有明确神经功能障碍的高血压基底节区出血患者，根据治疗方式的不同分为显微手术组和保守治疗组，显微手术组27例采用经侧裂-岛叶入路显微手术清除血肿，对照组35例采用保守治疗。术后6个月进行日常生活能力评分，比较两组患者预后差异。结果显微手术组治愈率明显高于保守治疗组，病残率明显低于保守治疗组，再出血率及病死率与保守治疗组比较差异无统计学意义。结论神经功能障碍症状明确的中少量高血压脑出血患者实施经侧裂-岛叶入路显微手术治疗，能显著改善其预后。

Study on the application of microsurgery through transsylvian - transinsular approach in treatment of hypertensive basal ganglia hemor- rhage with small to median volume.

Objective To evaluate the efficacy of microsurgery through transsylvian - transinsular approach in treatment of hypertensive basal ganglia hemorrhage with bleeding volume at 20 - 30 ml. Methods The clinical data of 62 patients with hypertensive cerebral hemorrhagic with small to median bleeding volume were enrolled in this retrospective study. According to the mode of treatment, all cases were divided into mi- crosurgery group and conservative treatment group. Transsylvian - transinsular microsurgery had been performed in 27 cases of microsurgery group, and non - operative treatment was performed in 35 cases of conservative treatment group. Activity of dally living at six months later had been meas- ured and compared between these two groups. Results The recovery rate of microsurgery group was significantly higher than that of conservative treatment group. The rate of disability was obviously decreased after microsurgery. The difference in rates of re - hemorrhage and mortality was not significant between these two groups. Conclusion Microsurgery through transsylvian - transinsular approach has significant therapeutic effect in treatment of patients with size of hematoma at 20 to 30 ml due to hypertensive cerebral hemorrhage.