经额中回入路显微手术治疗脑出血  

Microsurgical treatment of hypertensive hemorrhage through midfrontal gyrus approach

作　　者：张军臣[1] 王秀美[1] 邵彤[1] 赵万巨[1] 

机构地区：[1]济宁医学院附属医院神经外科,272029

出　　处：《临床神经外科杂志》2012年第3期172-173,共2页Journal of Clinical Neurosurgery

摘　　要：目的探讨经额中回入路显微手术治疗高血压脑出血的手术适应证、手术技巧。方法回顾性分析38例经额中回入路手术治疗高血压脑出血病例的临床资料。结果死亡4例,其中术后1年内死亡3例,1年后死亡1例,死亡原因:再次中风1例,颅内感染1例,心肌梗塞1例,肺功能衰竭1例。34例生存患者,ADLⅠ级1例,Ⅱ级10例,Ⅲ级17例,Ⅳ-Ⅴ级6例。结论向额叶方向扩展的壳核血肿或破入脑室的壳核、丘脑、尾状核血肿适宜经额中回入路,该手术入路有助于减少并发症。Objective To identify indication and surgical techniques of midfrontal gyms approach in patients with hypertensive hemorrage. Methods The clinical data of 38 patients with hypertensive hemorrhage through midfrontal gyms approach in our hospital from 2006 to 2008 was analyzed retrospectively. Results Four types of patients were treated with midfrontal approach. 21 patients were putamen hemotoma which expanse to the frontal lobe. 7 patients were Thalamic hematoma ruptured into the ventricle . 6 patients were Caudate hematoma ruptured into the ventricle. 4 patients were Primary intraventricular hematoma. Among the 34 cases of postoperative survival, 1 patient had ADL grade Ⅰ, 10 had grade Ⅱ, and 3 had grade 11,6 had grade Ⅳ or Ⅴ. Conclusion Microsurgical hematoma elimination through Inidfrontal approach are useful for patients which hemotoma lie putamen expanse to the frontal lobe and Thalamic hematoma, Caudate hematoma ruptured into the ventricle. Mierosurgical hematoma elimination through midfrontal approach eould effectively decrease the risk of complication.

关 键 词：颅内出血 高血压性 显微外科手术 额中回 

分 类 号：R651.1[医药卫生—外科学]