关键词: 小骨窗开颅经侧裂-岛叶入路显微手术, 骨瓣开颅手术, 基底节区脑出血

Abstract: Objective To investigate the effect of small bone window craniotomy via lateral fissure-insular approach and traditional bone flap craniotomy on cerebral hemorrhage in basal ganglia. Methods From October 2017 to October 2018， 60 patients with cerebral hemorrhage in basal ganglia were selected and divided into different groups according to the treatment plan， 30 cases in each group. The traditional group was treated with traditional craniotomy， while the small bone window group was treated with microsurgery via translateral fissure-insular approach. The operation conditions， Glasgow Coma Score （GCS） （before operation， 1 week after operation and 2 weeks after operation）， Pap index （BI） （1 month， 3 months and 6 months after operation）， and complications were compared between the two groups. Results Compared with the traditional group， the small bone window group had lower bleeding volume， shorter operation time and higher clearance rate of hematoma （P<0.05）； the GCS score of the small bone window group was higher than that of the traditional group one week after operation （P<0.05）； the BI of the small bone window group was higher than that of the traditional group one month and three months after operation （P<0.05）； the complication rate of the small bone window group was 3.33% lower than that of the traditional group 26.67% （P<0.05）. Conclusion Compared with traditional craniotomy， microsurgery via small bone window craniotomy via lateral Fissure-Insula approach has the advantages of less trauma， less bleeding， shorter operation time， higher clearance rate of hematoma and fewer complications， and which can also promote coma recovery and improve activities of daily life.

Key words: craniotomy with bone flaps, cerebral hemorrhage in basal ganglia, small bone window craniotomy via lateral fissure-insular approach