微创手术治疗重型高血压基底节区脑出血  

Minimally invasive operation in the treatment of severe hypertensive cerebral hemorrhage in basal ganglia

作　　者：宋清安[1] 陈志标[2] 

机构地区：[1]杭州市余杭区第二人民医院神经外科,杭州311121 [2]湖北医科大学附属第一医院神经外科,武汉430081

出　　处：《中国微创外科杂志》2005年第11期938-939,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨应用经侧裂微侵袭入路治疗重型高血压基底节区脑出血的临床效果。方法微创组28例,采用经侧裂微侵袭入路手术;对照组26例,采用传统血肿清除术治疗。比较2组近期(1个月)和远期(6个月)的疗效。结果在重型高血压基底节区脑出血救治方面,微创组的近期优良率53.6%(15/28)和病死率17.9%(5/28),与对照组近期优良率46.2%(12/26)和病死率15.4%(4/26)比较无明显差异(χ2=0.297,P=0.586;χ2=0.000,P=1.000)。但微侵袭组的远期存活患者的生存质量ADLⅠ～Ⅲ级(63.2%,12/19)优于对照组(23.6%,4/17)(z=-2.189,P=0.029)。结论微侵袭手术治疗重型高血压基底节区脑出血较传统血肿彻底清除术,能提高患者术后存活的生活质量,值得推广。Objective To investigate the clinical effect of minimally invasive surgery via basisylvian fissure approach in the treatment of severe hypertensive cerebral hemorrhage in basal ganglia. Methods The Study Group included 28 patients who received a minimally invasive surgery via basisylvian fissure approach, while the Control Group had 26 patients who underwent a traditional hematoma removal. Comparisons were made between the two groups on short -term （1 month） and long- term （6 months） effects. Results The rates of excellent or good short -term outcomes and mortalities were 53.6% （15/28） and 17.9% （5/28） in the Study Group, and 46.2% （12/26） and 15.4% （4/26） in the Control Group, respectively, without significant differences between the two groups （X^2 =0.297, P=0.586;X^2 =0.000, P=1.000）. However, the activity of daily life （ADL） grade Ⅰ- Ⅲ accounted for 63.2 % （12/19） of long -term survivors in the Study Group, which was superior to the Control Group （23.6% , 4/17 ） （z = -2. 189, P = 0. 029）. Conclusions Minimally invasive surgery for severe hypertensive cerebral hemorrhage in basal ganglia provides better life quality of survivors after operation than traditional hematoma removal.

关 键 词：高血压性 基底节区脑出血 微创手术 

分 类 号：R651.12[医药卫生—外科学]