超早期改良小骨窗入路显微镜下手术治疗基底节区脑出血78例

目的探讨高血压脑出血在发病超早期行改良小骨窗入路显微镜下手术治疗基底节区脑出血的临床疗效。方法回顾性分析我院2006年1月—2009年12月收治的78例高血压基底节区脑出血患者采用超早期改良小骨窗入路显微镜下手术清除血肿的临床资料。结果 78例患者中,血肿全部清除62例,大部分清除16例;术后再出血4例,其中2次手术2例。术后死亡11例。67例随访1年,按日常生活活动能力量表（ADL）分级,Ⅰ级11例,Ⅱ级29例,Ⅲ级19例,Ⅳ级5例,Ⅴ级3例。结论超早期改良小骨窗入路显微镜下手术清除高血压基底节区脑出血创伤小,时间短,易操作,适用于大部分高血压基底节区脑出血患者,能改善高血压脑出血的预后。

Microscopically craniotomy with modified small bone window approach in treatment of 78 cases of basal ganglia hemorrhage in ultra early stage

Objective To study the efficiency of microscopically craniotomy with modified small bone window approach in treatment of basal ganglia hemorrhage in ultra early stage.Methods The clinical data of 78 basal ganglia hemorrhage patients in our hospital from January 2006 to December 2009 treated by microscopically craniotomy with modified small bone window approach in ultra early stage were retrospective analyzed.Results In total 78 cases,all hematomas were removed in 62 cases and majority of hematoma were removed in 16 patients;postoperative rebleeding occurred in 4 cases,and there were 2 patients with second operation and 11 cases dead after operation.67 patients were followed-up for 1 years graded by ADL Barthel.Level Ⅰ were 11 cases,level Ⅱ were 29 cases,level Ⅲ were 19 cases,level Ⅳ were 5 cases,and level Ⅴ were 3 cases.Conclusion The microscopically craniotomy with modified small bone window approach treated basal ganglia hemorrhage had the characteristics of little trauma,less time consuming,easy to operate,it is suitable for most of basal ganglia hemorrhage and well to the prognosis.