高血压基底节出血显微手术治疗临床分析

【】目的探讨高血压基底节出血的显微外科治疗技巧、效果和预后。方法回顾分析2007年3月-2009年10月52例高血压所致基底节出血患者的临床表现、影像学资料、手术方式、治疗效果及随访资料。结果52例患者均于显微镜下清除血肿，无手术死亡。39例患者术后神经功能障碍得到改善，8例症状加重持续昏迷，5例术后1周死亡。术后随访6~18个月，35例生活基本能够自理日常生活能力量表（ADL）Ⅰ~Ⅲ级，12例长期卧床（ADLⅣ级）。结论采用显微外科技术治疗高血压基底节出血效果良好。【Abstract】ObjectiveToinvestigatethetechnique,effectiveness,andprognosisofmicrosurgicaltreatmentofhypertensivebasalgangliahemorrhage.MethodsAretrospectivestudywascarriedouton52patientswithhypertensivebasalgangliahemorrhagefromMarch2007toOctober2009.Theclinicalpresentation,neuroradiologicaldata,surgicalapproach,therapeuticefficacyandfollow-updatawerereviewed.ResultsAllofthehematomawereremovedundermicroscopewithoutsurgery-relateddeath.Afteroperation,thefunctionaldisordersofnervoussystemwereimprovedin39patients.Eightpatientsdeterioratedwithpersistentcomaafteroperation,fivepatientsdied.Thesurvivorswerefollowed-upforsixto18months.Thirty-fivepatientswereabletoself-carewithsomeefforts(ADLⅠ-Ⅲ),and12patientshadhemiparalysisorcoma(ADLⅣ).ConclusionMicrosurgeryisaneffectivetreatmentforhypertensivebasalgangliahemorrhagewithmicrosurgicaltechnique.