【摘要】 目的　探讨应用显微外科手术治疗高血压基底节区脑出血并脑疝的方法和临床疗效。　方法　对高血压基底节区脑出血并脑疝病例 ,采用额颞部骨窗开颅 ,去骨瓣减压 ,微创皮层造瘘 ,在手术显微镜下进行清除脑内血肿和止血。术后追踪 6个月 ,采用功能独立性测定 (FIM )进行脑卒中患者日常生活活动能力 (ADL)的评定。　结果　 60例中 ,死亡 9例 ,死亡率 15 %。术后随访 6～ 2 4个月 ,失访 1例 ,对存的活 5 0例根据FIMofADL进行评定 ,结果其中完全独立 3例 ,基本独立 4例 ,极轻度依赖绝大部分独立 5例 ,轻度依赖大部分独立 12例 ,中度依赖小部分独立 15例 ,重度依赖 4例 ,极重度依赖 3例 ,完全依赖 4例。　结论　采用额颞部骨窗开颅 ,微创皮层造瘘 ,就显微镜下清除脑内血肿和止血的方法 ,是治疗高血压基底节区脑出血并脑疝的有效方法之一。更多还原

【Abstract】 Objective To study the methods and curative effect of microsurgery treatment hypertensive basal ganglia hemorrhage complicated cerebral herniation. Methods Transfrontotemporal craniotomy,large decompressive craniotomies,cortex stoma is made by minimally invasive technique,remove intracranial hematom and withholding bleeding under microscope on 60 patients of hypertensive basal ganglia hemorrhage complicated cerebral herniation. Then follow-up 6～24 months after the operation,evaluate activities of daily living(ADL) by functional independence measure(FIM). Results Nine patients died among 60 cases,fatality was 15%. After operation there were 18 cases complicated gastrointestinal bleeding,37 cases complicated lung infection,3 cases were multiple organ failure. Follow-up 6～24 months,1 case was losed,3 patients showed completely independence,4 patients showed essential independence,5 patients need extreme mild-dependence,12 patients need mild-dependence,15 patients need moderate-dependence,4 patients need severe-dependence,3 patients need extreme severe-dependenec,4 patients need completely dependence. Conclusion Transfrontotemporal craniotomy,large decompressive craniotomies,cortex stoma is made by minimally invasive technique,remove intracranial herniation and with holding bleeding under microscope are an effective treatment for hypertensive basal ganglia hemorrhage complicated cerebral herniation.更多还原