基底节区脑出血选择外科治疗方法的探讨

目的:寻找治疗基底节区脑出血合适的外科方法.方法:回顾性分析了我们采用开颅显微外科手术及微创置管血肿引流手术治疗212例基底节区脑出血病人的结果.结果:未昏迷病人开颅手术与微创治疗的死亡率无显著性差异,而昏迷病人开颅手术的死亡率明显低于微创治疗者.结论:患者意识呈嗜睡或朦胧状态,血肿量一般在40 ml左右,适合血肿腔置管溶血引流术,手术在发病后12～ 24 h实施为宜；如病人入院时呈昏迷状态,血肿量通常超过50 ml,适宜显微镜下清除血肿,手术应尽早进行.

To Discuss the SurgicalTreatment of Cerebal Hemorrhage in Basal Ganglia

Objective:To find the appropriate surgical treatment of cerebral hemorrhage in basal ganglia.Methods: A retrospective analysis of 212 cases of cerebral hemorrhage in basal ganglion that treated with microsurgical craniotomy clearance of intracerebral hematoma and microdamage intubation drainage of intracerebral hemorrhage.Results: To the conscious patient,the mortality was no significant difference in two groups.To the unconscious patients,the mortality of craniotomy groups was significantly lower than that of minimally invasive treatment.Conclusion: If a patient did not enter a coma,somnolence or clouding of consciousness,the hematoma volume is about 40ml,this kind was fit micro-damage intubation drainage,surgery was performed after 12-24 hours of the illness onset is appropriate;if the patient has into a coma,hematoma volume is more than 50ml usual,that was suitable for microsurgical craniotomy clearance of intracerebral hematoma, surgery should be as soon as possible,according to the disease and intraoperative condition decision on whether decompressive craniectomy.