中小骨窗开颅加骨瓣复位术治疗幕上高血压脑出血87例临床分析  

Surgical treatment for supratentorial hypertensive intracerebral hematoma by modified minicraniotomy approach and bone fragment reduction

作　　者：刘占军[1] 岳树源[1] 

机构地区：[1]天津医科大学总医院神经外科,300052

出　　处：《中国综合临床》2012年第4期423-425,共3页Clinical Medicine of China

摘　　要：目的探讨中小骨窗开颅＋骨瓣复位术治疗幕上高血压脑出血的技巧及疗效。方法回顾性分析我院2009年4月至2011年4月采用中小骨窗开颅＋骨瓣复位术治疗的87例幕上高血压脑出血患者的临床资料。结果87例患者术后死亡3例，余84例术后6个月进行随访，按日常生活能力（ADL）分级评定：I级26例，Ⅱ级28例，Ⅲ级22例，Ⅳ级6例，V级2例。结论中小骨窗开颅＋骨瓣复位术治疗幕上高血压脑出血，暴露良好，视野广，脑组织损伤小，血肿清除彻底，无颅骨缺损，并发症少，为理想的幕上高血压脑出血手术治疗方式。Objective To explore the techniques and clinical effects of surgical treatment for supratentorial hypertensive intracerebral hematoma （HICH） by modified minicraniotorny approach and bone fragment reduction. Methods The clinical data of 87 patients with supratentorial HICH in our department from April ,2009 to April ,2011 who received modified minicraniotomy approach and reduction of bone fragment were retrospectively reviewed. Results Of the 87 patients, three died, and the remaining 84 cases were followed up. According to the ADL（ activities of daily living） scale, the patients were classified ：Twenty-six cases in grade Ⅰ ,28 in grade Ⅱ ,22 in grade Ⅲ, 6 in grade Ⅵ and 2 in grade Ⅴ. Conclusion The surgical procedure of modified minicraniotomy approach and reduction of bone fragment for treatment of supratentorial HICH has some advantages such as miniinvasion, good exposure, wide visual field, complete clearance of hematoma, integrated skull, and less complications. It is a perfect surgical procedure for supratentorial HICH.

关 键 词：脑出血 高血压 骨瓣复位术 

分 类 号：R651.1[医药卫生—外科学]