[1]刘永,张玉海,何升学,等.经外侧裂岛叶入显微清除高血压性基底节区脑出血[J].临床神经外科杂志,2015,(05):375-378.
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经外侧裂岛叶入显微清除高血压性基底节区脑出血()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
期数:
2015年05期
页码:
375-378
栏目:
论著
出版日期:
2015-10-15

文章信息/Info

Title:
Transsylvian-transinsular approach for the microsurgical removal of hypertensive basal ganglia hemorrhage
作者:
刘永 张玉海 何升学 赵金兵 朱海涛 张光绪 梁正
南京医科大学附属脑科医院
关键词:
外侧裂-岛叶入路基底节区脑出血显微手术
Keywords:
transsylvian-transinsular approachbasal gangliacerebral hemorrhagemicrosurgery
分类号:
R651.1
文献标志码:
A
摘要:
目的 探讨在显微镜下经外侧裂-岛叶入路清除高血压性基底节区脑出血的手术要点及脑组织和血管保护。方法 回顾性分析18例经外侧裂-岛叶入路显微手术清除基底节区高血压脑出血患者临床资料。结果 本组男性13例,女5例,平均年龄49.22岁。血肿量30~40ml 4例,40~50ml 7例,50ml以上7例。术后复查头颅CT了解血肿清除情况,血肿清除>90% 16例,80%~90% 1例。再出血1例。本组1例患者因术后严重肺部感染死亡。随访3~6月,KPS 90~100分3例,60~80分9例,30~50分4例,10~20分1例。结论 经外侧裂-岛叶入路有利于保护重要的大脑皮层和血管,是显微清除高血压性基底节区脑出血安全有效的手术方式。
Abstract:
Objective To explore the key points of transsylvian-transinsular approach to remove the hypertensive basal ganglia hemorrhage and adjacent brain tissue and blood vessels protection. Methods The clinical data of 18 patients who underwent the transsylvian-transinsular approach to remove the hypertensive basal ganglia hemorrhage were analyzed retrospectively. Results Thirteen males and five females patients were included in our group,with an average age of 49.22 years.According to hematoma volumes, patients were classified into 3 groups i.e.30 ~ 40 ml 4 cases, 40 ~ 50 ml 7 cases, over 50 ml 7 cases.The volume of remaining hematoma was evaluated by postoperative CT scan.The evacuation rate of hematoma was >90% in 16 patients and 80%-90% in 1.One case occured rehemorrhage.One patient died from severe pulmonary infection.A follow-up study of 3~6 months showed KPS was 90~100 in 3 patients, 60~80 in 9,30~50 in 4 and 10~20 in 1. Conclusion The transsylvian-transinsular approach was benefit to protect important cerebral cortex and vessels,thus being a safe and effective operation method for microscopic removal of hypertensive basal ganglia hemorrhage.

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备注/Memo

备注/Memo:
[收稿日期] 2015-01-13 [基金项目]江苏省卫计委科技项目(H201242);南京医科大学科技发展基金(2012NJMU111)
更新日期/Last Update: 2015-10-15