Toth水解剖技术在高血压壳核出血显微手术中的应用  

Water Dissection Technique of Toth for the Treatment of Hypertensive Intracerebral Putamen Hemorrhage

作　　者：吴建东[1] 惠国桢[2] 钱苏荣[1] 林荔清[1] 王晨秋[1] 王剑韧[1] 王晨[1] 殷光中[1] 

机构地区：[1]南京医科大学附属苏州医院神经外科,江苏苏州215008 [2]苏州大学附属第一医院神经外科,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2008年第6期984-986,共3页Suzhou University Journal of Medical Science

摘　　要：目的探讨Toth水解剖技术用于小骨窗经侧裂入路手术治疗高血压壳核出血的可行性。方法20例高血压壳核出血行小骨窗经侧裂入路手术,采用Toth水解剖技术清除血肿。对术后4～12个月内的日常生活能力(ADL)进行分级。结果无1例死亡,生存者的ADL分级为:1～2级(完全或部分生活自理)10例,3级(可在搀扶下下地活动)5例,4级(意识清楚,卧床不起)4例,5级(植物生存状态)1例。结论Toth水解剖技术用于小骨窗经侧裂入路手术治疗高血压壳核出血简单、安全、有效。Objective To investige the possibility of water dissection technique of Toth for cran-iotomy with small bone flap through lateral fissure approach for the treatment of hypertensive intracere-bral putamen hemorrhage.Methods Twenty consecutive patients with hypertensive intracerebral puta-men hemorrhage were treated by making a incision on sclap long about 6 cm across sylvian fissure,making a small bone flap about 3 cm ×3 cm,After opening dual,we injected water under microscopic control by a handheld syringe with a blunt needle applying repeated injection of physiological saline in-to the sylvian fissure to open it,opening the insular cortex,evacuation of intracerebral hematoma.Re-sults There was no further mortality.Patients who returned to ADL 1 and 2（good recovery） after surgi-cal treatment were 10,ADL 3 were 5,ADL 4 were 4,ADL 5 were 1.Conclusion A method of water dissection technique of Toth for craniotomy with small bone flap through lateral fissure approach for the treatment of hypertensive intracerebral putamen hemorrhage is a method of convenient,safe,and with effective result.

关 键 词：水解剖技术 高血压壳核出血 小骨窗 外侧裂 

分 类 号：R651.11[医药卫生—外科学]