【摘要】 目的探讨小骨窗开颅治疗高血压基底节区脑出血的手术适应证、手术技巧及疗效评价。方法总结该院1994￣2003年205例分别经传统骨瓣和小骨窗开颅手术治疗的高血压基底节区脑出血病人的病历资料,并进行对比分析。结果小骨窗组105例,手术时间60￣90min,平均70min,术中出血50￣150mL,平均80mL。再出血4例(3.8%)。死亡率20%,恢复良好率37%,中度病残率40%,重度病残率23%。传统骨瓣组100例,手术时间95￣180min,平均120min;术中出血120￣350mL,平均210mL。再出血3例(3%)。死亡率29%,恢复良好率26%,中度病残率37%,重度病残率37%。结论小骨窗开颅具有操作简便、手术时间短、创伤小、止血可靠、疗效好等优点,是治疗高血压基底节区脑出血的一种较好方法。更多还原

【Abstract】 [Objective]To discuss the indications of surgical treatment, the surgical approach and skill of key-hole craniectomy for hypertensive ganglionical hemorrhage and to appraise the effect of it. We summarized 205 cases in our hospital of key-hole craniectomy and conventional craniectomy for hypertensive ganglionical hemorrhage from 1994~2003, compared and analysed them. In key-hole group (105), the operating time was 60~90 minutes with an average of 70 minutes, the amount of bleeding during operations was 50~150mL with an average of 80 mL, recurrent hemorrhage occurred in 4 patients(3.8%), 20% were dead, 37% restored to good condition, 40% were moderate disabled and 23% were severely disabled. In conventional group(100), the operating time was 95~180 minutes with an average of 120 minutes ,the amount of bleeding during operations was 120~350 mL with an average of 210 mL, recurrent hemorrhage occurred in 3 patients(3%), 29%were dead, 26% restored to good condition, 37% were moderate disabled and 37% were severely disabled. [Conclusion] Key-hole craniectomy is easy to be operated, it requires short operating time and lead to little trauma, also it is a tried hemostasis and has good effect, it is a better therapy for hypertensive ganglionical hemorrhage.更多还原