摘要
目的 探讨应用小骨窗经侧裂入路显微手术治疗中重度壳核脑出血的临床效果。方法 5 1例中重度壳核脑出血均采用小骨窗经侧裂入路进行手术治疗。头皮切口相当于外侧裂颅骨投影线 ,骨瓣直径约 3cm。打开外侧裂池分开外侧裂 ,切开岛叶皮质后清除血肿。结果 死亡 11例 ,死亡率 2 1 5 7%。预后按ADL日常生活能力分级法进行评测 :1级 (完全恢复 ) 2例 ,2级 (部分恢复或可独立生活 ) 6例 ,3级 (需人帮助 ,扶拐可行 ) 15例 ,4级 (卧床但保持意识 ) 8例 ,5级 (植物生存 ) 2例。结论 小骨窗开颅手术创伤小 ,其疗效与大骨窗无显著差异 ;经侧裂入路具有达到血肿路程短 。
Objective To explore clinical effects of micro-nurosurgical treatment with small craniotomy lateral fissure approach to treat moderate or severe intraceral hemorrhage from putamen.Methods All of 51 patients with moderate or severe intracerebral hemorrhage were subjected to surgical treatment.Scalp incision was approximate the projection of lateral fissure on head,the diameter of the window of bone was about 3cm.The lateral fissure was opened by anatomizing sylvian cistern.After incising the cortex of insular,hemotoma was removed.Results 11 cases were dead,the mortality was 21 57%.The ADL was accepted as a standard means of describing outcome in these patients .2 cases,were subjected to Grade Ⅰ,6 cases for GradeⅡ,15 cases for GradeⅢ,8 cases for Grade Ⅳ,2 cases for Grade Ⅴ.Conclusions There is no significant difference of outcome between small craniotomy and craniotomy.(Lateral fissure approach) Transsylvian route is very directly for deep hemotomas,and brain injury caused by approach also is very light.
出处
《中国医师杂志》
CAS
2003年第4期472-474,共3页
Journal of Chinese Physician
关键词
小骨窗
外侧裂入路
脑出血
显微外科技术
Small craniotomy
Lateral fissure approach
Intracerebral hemorrhage
Technique of micro-neurosurgery
