摘要
目的探讨并比较采用两种不同切口开颅清除自发性高血压性基底节脑内血肿后的并发症情况。方法回顾性分析同济大学附属上海市东方医院神经外科自2010年1月至2011年12月手术治疗的58例自发性高血压性基底节脑内血肿患者的临床资料，其中A组（手术时间2010年1月至12月底）27例采用扩大翼点入路切口，B组（手术时间2010年12月底至2011年12月）31例采用围绕外耳道的马蹄形切口。结果58例患者中术后死亡1例，存活57例：日常生活能力评分为I级18例，Ⅱ级26例，Ⅲ级8例，Ⅳ级5例，V级1例。A组术后发生硬膜外血肿3例，拆线后耳前动脉喷血1例．皮下积液5例：B组术后均未发生硬膜外血肿，仅有面神经颞支损伤5例；与A组比较，B组具有较少的并发症发生率，差异有统计学意义（X2=4．660，P=-0．012）。结论采用围绕外耳道的马蹄形切口开颅清除自发性高血压性基底节脑内血肿的手术并发症发生率相对较低。
Objective To compare the complications of spontaneous hypertensive intracerebral hematoma located in the basal ganglion after being treated with two different incision craniotomies. Methods The clinical data of 58 patients with spontaneous hypertensive intracerebral hematoma located in the basal ganglion, admitted to our hospital and performed hematoma resection fi＇om January 2010 to December 2011, were retrospectively analyzed; in these 58 patients, 27 （group A） adopted expanded transpterional approach and the other 31 （group B） chose horseshoe-shaped incision around the external auditory canal. Results In all these 58 patients, one patient died and 57 survived. According to the activity of daily living test, 18, 26, 8, 5 and 1 patients were in grade I, grade Ⅱ, grade Ⅲ, grade IV and grade V, respectively. The complications of group A were as follows： epidural hematoma was noted in 3 patients; blood spurting of the superficial temporal artery after being removed the stitches in 1 patient, and subcutaneous hydrops in 5 patients; the complications in group B only included temporal facial nerve injuries in 5 patients; the complication rate in group A was significantly higher than that in group B （X2=4. 660, P=0.012）. Conclusion Removal of hematoma of the basal ganglion using horseshoe-shaped incision craniotomy is the appropriate method enjoying fewer complications.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2013年第2期175-178,共4页
Chinese Journal of Neuromedicine
关键词
高血压脑出血
基底节
并发症
扩大翼点入路
马蹄形切口
Hypertensive intracerebral hemorrhage
Basal ganglion
Complication
Expanded transpterional approach
Horseshoe-shaped incision
