经外侧裂入路小骨窗血肿清除术治疗高血压基底节区出血疗效观察

目的 观察经外侧裂入路小骨窗血肿清除术治疗高血压基底节区出血的疗效.方法 我院2009-01-2012-01应用经外侧裂入路小骨窗血肿清除术治疗高血压基底节区出血患者34例（观察组）,与同期采用常规骨瓣开颅清除术治疗的30例患者作对照,对比2组患者术后2周格拉斯哥昏迷评分（GCS）及术后6个月格拉斯哥顶后评分（GOS）,观察2组再出血情况.结果 2组术后2周GCS评分及术后6个月GOS评分比较差异有统计学意义（P＜0.05）,观察组疗效优于对照组.观察组再出血率8.8%（3/34）,对照组为16.7%（5/30）,2组比较差异有统计学意义（P＜0.05）.结论 外侧裂入路小骨窗血肿清除术治疗高血压基底节区出血创伤小,患者恢复快,血肿清除彻底,术后患者再出血率低,疗效优于传统开颅血肿清除术,值得基层医院推广使用.

Clinical observation on efficacy of small skull window removal of hematoma via transsylvian approach on hypertensive intracerebral hemorrhage in basal ganglia region

Objective To observe the efficacy of small skull window removal of hematoma via transsylvian approach on hypertensive hemorrhage in basal ganglia region. Methods Thirty-four patients with hypertensive intracerehral hematoma in basal ganglia region accepted small bone removal of hematoma through transsylvian approach from Jan 2009 to Jan 2012 as observa- tion group）. Thirty patients with conventional craniotomy in synchronization as control group. The glasgow coma scale（GCS） at 2 weeks after operation and glasgow top score（GOS） at 6 months after operation in two groups were compared, and the ratio of rehaemorrhagia was observed. Results GCS and GOS score in two groups had statistical significance（P（0.05）, and ratio of rehaemorrhagia in observation group was 8.8 % （3/34）, control group was 16.7% （5/30）, and there was statistical signifi- cance（P〈0.05）. Conclusion Small skull window removal of hematoma via transsylvian approach is a minimally invasive method which has little damage,good recovery, rather complete hematoma removal,low rate of rehaemorrhagia, and is better than the traditional craniotomy, so it is worth of promotion in primary hospitals.