【摘要】 目的 探討高血壓基底節(jié)出血的顯微外科治療技巧、效果和預(yù)后。 方法 回顧分析2007年3月-2009年10月52例高血壓所致基底節(jié)出血患者的臨床表現(xiàn)、影像學(xué)資料、手術(shù)方式、治療效果及隨訪資料。 結(jié)果 52例患者均于顯微鏡下清除血腫，無手術(shù)死亡。39例患者術(shù)后神經(jīng)功能障礙得到改善，8例癥狀加重持續(xù)昏迷，5例術(shù)后1周死亡。術(shù)后隨訪6~18個(gè)月，35例生活基本能夠自理[日常生活能力量表（ADL）Ⅰ~Ⅲ級(jí)]，12例長期臥床（ADL Ⅳ級(jí)）。 結(jié)論 采用顯微外科技術(shù)治療高血壓基底節(jié)出血效果良好。
【Abstract】 Objective To investigate the technique, effectiveness, and prognosis of microsurgical treatment of hypertensive basal ganglia hemorrhage. Methods A retrospective study was carried out on 52 patients with hypertensive basal ganglia hemorrhage from March 2007 to October 2009. The clinical presentation, neuroradiological data, surgical approach, therapeutic efficacy and follow-up data were reviewed. Results All of the hematoma were removed under microscope without surgery-related death. After operation, the functional disorders of nervous system were improved in 39 patients. Eight patients deteriorated with persistent coma after operation, five patients died. The survivors were followed-up for six to 18 months. Thirty-five patients were able to self-care with some efforts (ADL Ⅰ-Ⅲ), and 12 patients had hemiparalysis or coma (ADL Ⅳ). Conclusion Microsurgery is an effective treatment for hypertensive basal ganglia hemorrhage with microsurgical technique.
引用本文： 彭俊,張明偉,范秀云,曹相軍. 高血壓基底節(jié)出血顯微手術(shù)治療臨床分析. 華西醫(yī)學(xué), 2010, 25(8): 1448-1449. doi: 復(fù)制
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- 2. Youman S JR. Neurological Surgery[M]. Philadelphia: Saunders, 1984: 851-854.
- 3. 劉承基. 腦血管病外科治療[M]. 南京: 江蘇科學(xué)技術(shù)出版社, 1987: 243-247.
- 4. 朱風(fēng)清. 超早期手術(shù)治療高血壓背殼出血的療效分析[J]. 中華神經(jīng)外科雜志, 1987, 3: 108.
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- 7. Sutherland GR, Auer RN. Primary intracerebral hemorrhage[J]. J Clin Neurosci, 2006, 13(5): 511-517.
- 8. 左右, 陳健良, 吳耀晨, 等. 高血壓腦出血小切口微創(chuàng)手術(shù)治療[J]. 中國醫(yī)師雜志, 2004, 6(5): 580-582.
- 9. Eisner W, Schmid UD, Reulen HJ, et al. The mapping and continuous monitoring of the intrinsic motor nuclei during brain stem surgery[J]. Neurosurgery, 1995, 37(2): 255-265.