显微镜下经外侧裂清除高血压壳核血肿的手术体会

目的:探讨显微镜下经外侧裂-岛叶入路治疗30例高血压壳核出血的手术体会。方法:选择高血压壳核出血患者30例,采取经翼点-外侧裂-岛叶入路显微手术治疗高血压壳核出血的方法,观察记录上述患者手术一般资料及手技体会、手术治疗临床效果及术后第6个月患者的恢复情况。结果:上述患者平均输血量93.3±45.6ml,平均手术时间2.5±0.4小时,平均住院时间23.1±3.3天;血肿清除量>90%者18例,80%～70%者10例,<70%者2例;术后第6个月评价上述患者的ADL,Ⅰ级7例(23.3%),Ⅱ级13例(43.3%),Ⅲ级8例(26.7%),Ⅳ级2例(6.7%),Ⅴ级0例(0.0%),临床疗效满意病例20例(66.7%)。结论:经外侧裂显微手术治疗壳核出血,具有手术时间短、患者创伤小、术后恢复快的优点,值得临床推广。

The Clinical Observation of Treating 30 Patients with theHypertensive Putamen Hemorrhage by the Microsurgery

Objective: To evaluate the clinical effect of microsurgery in treating 30 patients with the hypertensive putamen hemorrhage.Method:Collect 30 patients with the hypertensive putamen hemorrhage,they were all treated by the microsurgery,then comparing the general surgery situation,the clinical effect after the surgical treatment and the patient’s recovery after six months.Result:The average amount of blood transfusion was 93.3±45.6ml,the average operative time was 2.5±0.4 hours,the average hospital stay was 23.1±3.3 days;hematoma volume>90% in 18 cases,80% to 70% in 10 patients,<70% in 2 cases;Ⅰ grade 7 cases(23.3%),Ⅱ grade 13 cases(43.3%),Ⅲ grade 8 cases(26.7%),Ⅳ grade 2 cases(6.7%),Ⅴ grade 0 cases(0.0%),20 patients’ clinical effect were satisfactory(66.7%).Conclusion:The microsurgical treatment in lateral fissure putamen hemorrhage was with the shorter operative time,the small patient trauma,the rapid postoperative recovery,it was worth to be widely implemented.