经侧裂入路显微手术治疗基底节区脑出血优、劣势的分析  

Analysis of Advantages and Disadvantages of Treatment of the Cerebral Hemorrhage in Basal Ganglia Patients with Microneurosurgery via Lateral Fissure

作　　者：丁正斌[1] 周向阳[1] 李益民[1] 陈江宏[1] 曾志青[1] 

机构地区：[1]南华大学附属第一医院神经外科,湖南衡阳421001

出　　处：《中南医学科学杂志》2015年第6期655-657,共3页Medical Science Journal of Central South China

摘　　要：目的：对比显微镜下从外侧裂入路与常规经皮质入路手术治疗基底节区脑出血的优势和劣势,并分析手术治疗该病的入路选择。方法回顾分析我科2012年5月~2014年5月200例基底节区脑出血达到外科开颅血肿除术指征患者各100例,采取两种不同入路（即从外侧裂或经皮质常规入路）经治疗后,并对比和分析经这两种入路手术方法治疗的两组患者的预后。结果随访半年以上,常规入路治疗100例病人85例生活可以自理,8例生活需人照顾,3例死亡,4例因效果不佳,治疗时间及费用问题,家属放弃治疗；经外侧裂显微入路治疗100例,87例生活可自理,9例需人照顾,2例死亡,2例放弃治疗。结论两种手术入路各有其优势和劣势,其选择要根据患者术前病情轻重缓急而决定,正确的手术入路对患者预后有明显的改善,而不是盲目地一味选择经外侧裂入路。Objective To investigate the advantages and disadvantages of the lateral fissure approach and conven-tional approach ,and to choose the right approach to treat the cerebral hemorrhage in basal ganglia patients. Methods 200 patients with cerebral hemorrhage in the basal ganglia area were retrospectively analyzed,two approach of operation were used in the patients who got the cerebral hemorrhage in the basal ganglia region （ operation via lateral fissure approach or conventional approach） ,respectively. Results Following up half year or more after operation,among patients with con-ventional approach,85 can take care of themselves,8 need to be cared for,3 were dead,4 gave up treatment due to all kinds of reasons;among patients with microneurosurgery,87 can take care of themselves,9 need to be cared for,2 were dead,2 gave up treating. Conclusion Two surgical approaches have their advantages and disadvantages,respectively. The select-ed surgical approach was determined by the preoperative condition and prognosis,rather than blindly choosing microsurgery via a lateral fissure approach.

关 键 词：基底节脑区 脑出血 外侧裂入路 显微手术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]