【摘要】 目的 探討高血壓基底節出血的顯微外科治療技巧、效果和預后。 方法 回顧分析2007年3月-2009年10月52例高血壓所致基底節出血患者的臨床表現、影像學資料、手術方式、治療效果及隨訪資料。 結果 52例患者均于顯微鏡下清除血腫，無手術死亡。39例患者術后神經功能障礙得到改善，8例癥狀加重持續昏迷，5例術后1周死亡。術后隨訪6~18個月，35例生活基本能夠自理[日常生活能力量表（ADL）Ⅰ~Ⅲ級]，12例長期臥床（ADL Ⅳ級）。 結論 采用顯微外科技術治療高血壓基底節出血效果良好。
【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. 高血壓基底節出血顯微手術治療臨床分析. 華西醫學, 2010, 25(8): 1448-1449. doi:
復制
| 1. |
王忠誠. 神經外科學[M]. 武漢: 湖北科學技術出版社, 2004: 869-870.
|
| 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: 江蘇科學技術出版社, 1987: 243-247.
|
| 4. |
朱風清. 超早期手術治療高血壓背殼出血的療效分析[J]. 中華神經外科雜志, 1987, 3: 108.
|
| 5. |
王忠誠, 吳中學, 趙繼宋, 等. 高血壓腦出血預后影響因素分析[J]. 中華神經外科雜志, 1990(6): 73.
|
| 6. |
Fewel ME, Thompson BG Jr, Hoff JT. Spontaneous intracerebral hemorrhage: a review[J]. Neurosurg Focus, 2003, 15(4): 1.
|
| 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手術治療[J]. 中國醫師雜志, 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.
|
- 1. 王忠誠. 神經外科學[M]. 武漢: 湖北科學技術出版社, 2004: 869-870.
- 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: 江蘇科學技術出版社, 1987: 243-247.
- 4. 朱風清. 超早期手術治療高血壓背殼出血的療效分析[J]. 中華神經外科雜志, 1987, 3: 108.
- 5. 王忠誠, 吳中學, 趙繼宋, 等. 高血壓腦出血預后影響因素分析[J]. 中華神經外科雜志, 1990(6): 73.
- 6. Fewel ME, Thompson BG Jr, Hoff JT. Spontaneous intracerebral hemorrhage: a review[J]. Neurosurg Focus, 2003, 15(4): 1.
- 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手術治療[J]. 中國醫師雜志, 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.
