经颞下岩前入路手术治疗高血压性脑干出血  

Surgical treatment of hypertensive brainstem hemorrhage via infratemporal-prepetrosal approach

作　　者：许志剑 徐虎[1] 余丹枫 杨帆[1] 周格知[1] XU Zhi-jian;XU Hu;YU Dan-feng(Department of Neurosurgery,Jinhua Municipal Central Hospital,Jinhua 321000,China)

机构地区：[1]金华市中心医院神经外科

出　　处：《临床神经外科杂志》2019年第6期497-499,506,共4页Journal of Clinical Neurosurgery

摘　　要：目的研究经颞下岩前入路手术治疗高血压相关性脑干出血的可行性及疗效。方法回顾性分析26例经颞下岩前入路手术治疗的高血压性脑干出血患者的临床资料。结果所有患者经手术均成功清除血肿,其中11例患者的血肿完全清除,15例患者的血肿大部分清除。术后随访3个月,本组患者中,手术后死亡者5例,病死率19.2%;格拉斯哥预后量表(Glasgow outcome scale,GOS)评分5分者1例、4分者7例、3分者8例、2分5例、1分5例,恢复良好(GOS评分≥4分)率30.8%(8/26例)。结论对于具备适应证的高血压性脑干出血患者,应积极尽早行外科手术治疗;采用经颞下岩前入路是一种理想的、安全可行的手术方式。Objective To investigate the feasibility and efficacy of infratemporal-prepetrosal approach in the treatment of hypertensive brainstem hemorrhage.Methods The clinical data of 26 patients with hypertensive brainstem hemorrhage which were treated via infratemporal-prepetrosal approach were analyzed retrospectively.Results The hematomas in all patients were successfully removed,11 cases were totally removed,15 were sub-totally removed.The patients were followed up for 3 months.There were 5 patients died after the operation and the mortality rate was 19.23%.The patients were evaluated by Glasgow outcome scale(GOS)and the results showed grade 5 in 1 case,grade 4 in 7,grade 3 in 8 and grade 2 in 5.The rate of GOS≥4 was 30.8%(8/26).Conclusions For patients with surgical indications of the hypertensive brainstem hemorrhage,the surgical intervention should be taken as soon as possible.The infratemporal-prepetrosal approach is an ideal,safe and feasible surgical plan.

关 键 词：高血压 脑干出血 颞下岩骨前入路 显微手术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]