经侧裂入路显微手术治疗基底节脑出血临床分析

【目的】研究经侧裂入路显微手术治疗基底节脑出血方法及疗效。【方法】将74例基底节脑出血患者随机分成两组，33例经侧裂入路显微手术清除血肿，41例行传统的经颞叶皮质造瘘手术清除血肿，将2组资料做对比研究。【结果】经侧裂手术组术后3d内复查头颅CT显示血肿清除程度满意，均在90％以上，无再出血发生，无死亡病例。随访3～6个月，术后3个月时按日常活动生活质量标准（ADL）评价：Ⅰ级3例，Ⅱ级5例，Ⅲ级15例，Ⅳ级7例，Ⅴ级3例，与传统手术组比较，有统计学差异。【结论】经侧裂入路显微手术治疗基底节脑出血是一种损伤轻、疗效优、预后好的微创治疗方法。

Microsurgery via transsylvian fissure-insular approach for treating intracerebral hematomas in basal ganglia region

[Objective] To study the method and effects of clearing hematoma in basal ganglia region by microneurosurgery via transsylvian fissure-insular approach. [Methods] A total of 74 cases of cerebral hematomas in basal ganglia region were divided in two groups. The first group （33 cases） were treated with microneurosurgery via transslvian fissure approach and the second （41 cases） by transcotical approach. The data of two groups were compared. [Results] In group of transsylvian fissure-insular approach CT re-examination within 72 h after operation showed that the hematoma was removed by over 90% in all cases; no postoperative rebleeding or death. 3 - 6 months follow-up, patients were evaluated by activities of daily living （ADL） 3 - 6 months after operation, Grade Ⅰ 3 cases, Ⅱ 7 cases, Ⅲ 15 cases, Ⅳ 5 cases and Ⅴ3 cases. There was significant difference in ADL between two groups. [ Conclusions] Microneurosurgical treatment via transsylvian fissure-insular approach for cerebral hematomas in basal ganglia region is a minimall invasive method with less damage, better effects and more favorable prognosis.