经颞叶-经岛叶入路治疗大脑外侧丘脑大型出血。

Transsylvian-transinsular approach to large lateral thalamus hemorrhages.

作者信息

Zhang Hong-Tian, Shang Ai-Jia, He Bing-Juan, Xu Ru-Xiang

机构信息

From the *The Affiliated Bayi Brain Hospital, Military General Hospital of Beijing PLA; †Institute of Neurosurgery, Beijing Military Region PLA; and ‡Department of Neurosurgery, General Hospital of Chinese PLA, Beijing, China.

出版信息

J Craniofac Surg. 2015 Mar;26(2):e98-102. doi: 10.1097/SCS.0000000000001323.

DOI:10.1097/SCS.0000000000001323

PMID:25675015

Abstract

Here, we aimed to evaluate the experience of transsylvian-transinsular microsurgical approach (TTH) to the huge lateral thalamic hemorrhages (THs). A total of 37 patients with huge lateral TH (hematoma volumes between 30 and 90 cm) who underwent surgical treatment through middle or distal TTH at the Bayi Brain Hospital from January 2007 to May 2012 were included in this series. By using TTH, near-complete (99%) evacuation was achieved in 29 patients (78.4%). Glasgow Coma Scale (GOS) scores were significantly improved at discharge compared with admission scores (P < 0.001). The overall survival rate at 3 months was 81.08% (30/37), including 51.35% (19/37) with good function (GOS, 4-5), 13.51% (5/37) with disability (GOS, 3), and 16.22% (6/37) in a vegetative state (GOS, 2). The mortality rate (GOS, 1) was 18.92% (7/37). Our series showed that, according to the extension direction of hematomas, to select middle or distal TTH is effective and safe for TH.

摘要

在此，我们旨在评估经外侧裂-岛叶显微手术入路（TTH）治疗巨大外侧丘脑出血（TH）的经验。本研究纳入了2007年1月至2012年5月期间在八一脑科医院通过中入路或远入路TTH接受手术治疗的37例巨大外侧TH患者（血肿体积在30至90立方厘米之间）。采用TTH，29例患者（78.4%）实现了近完全（99%）血肿清除。与入院时相比，出院时格拉斯哥昏迷量表（GOS）评分显著改善（P<0.001）。3个月时的总生存率为81.08%（30/37），其中功能良好（GOS，4 - 5分）者占51.35%（19/37），残疾（GOS，3分）者占13.51%（5/37），植物状态（GOS，2分）者占16.22%（6/37）。死亡率（GOS，1分）为18.92%（7/37）。我们的研究系列表明，根据血肿的扩展方向选择中入路或远入路TTH治疗TH是有效且安全的。