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

摘要： 目的 探究小骨窗开颅经侧裂-岛叶入路显微手术和传统骨瓣开颅手术治疗基底节区脑出血的效果。方法 选取我院2017年10月～2018年10月基底节区脑出血患者60例，根据治疗方案不同分组，各30例。传统组给予传统骨瓣开颅手术治疗，小骨窗组给予小骨窗开颅经侧裂-岛叶入路显微手术治疗。对比两组手术情况、格拉斯哥昏迷评分（GCS）（术前、术后1周、术后2周）、巴氏指数（BI）（术后1个月、术后3个月、术后6个月）、并发症。结果 与传统组相比，小骨窗组术中出血量较低，手术时间较短（P<0.05）；小骨窗组术后1周GCS评分较传统组高（P<0.05）；术后1个月、术后3个月小骨窗组BI较传统组高（P<0.05）；小骨窗组并发症发生率3.33%较传统组26.67%低（P<0.05）。结论 与传统骨瓣开颅手术相比，小骨窗开颅经侧裂-岛叶入路显微手术治疗基底节区脑出血，具有创伤小、出血少、手术时间短、并发症少等优势，并可促进患者昏迷恢复，提高日常生活活动能力。

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