【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.
