小骨窗开颅经侧裂高血压脑出血显微外科治疗

目的：探讨经侧裂入路显微手术治疗壳核区高血压脑出血的效果,总结临床经验.方法：回顾我院于2001年1月-2007年2月收治的壳核或以壳核为主的高血压脑出血患者246例,均采用小骨窗经外侧裂入路在显微镜下清除血肿.结果：全部病例血肿清除满意.血肿完全清除231例（93.9%）,近全清除15例（6.1%）.术后无一例血肿复发.无手术死亡病例.结论：本手术方法不受出血时间的限制;不受血肿量大小的限制;能充分利用脑组织正常间隙及非重要功能区进行操作,脑组织损伤小,减少了手术的创伤;能够清晰看清出血点,更准确有效地止血,降低了手术后再出血的风险;血肿彻底清除.

Evacuation of Hematoma of Hypertensive Cerebral Hemorrhage with Craniotomy with Small Bone Flap via Lateral Fissure

Objective:To study the clinical effect of microsurgery via lateral fissure treating hypertensive cerebral hemorrhage in putaminal region and summarize the clinical experience.Methods:Craniotomy with small bone flap via lateral fissure were applied to evacuate hematoma originating from hypertensive cerebral hemorrhage in putamen and periputaminal region.246 cases from January 2001 to February 2007 were analyzed retrospectively.Results:The effect of this method was satisfactory.Total evacuation was achieved in 231 cases(93.9%),partial evacuation in 15 cases(6.1%).No hematoma reccurred in any case.No patient died.Conclusion:This method has no limit to bleeding time and amount of bleeding and exerts less impairment on normal brain tissue by manipulation through normal anatomical spaces and unimportant domain.It possesses the merits of finding bleeding part quickly,performing hemostasis effectively,reducing secondary bleeding and evacuating hematoma thoroughly.