中国临床神经外科杂志

目的 探讨经耳前-颞下入路锁孔手术治疗原发性脑干出血的临床效果。方法 回顾性分析2019年2月至2022年4月经耳前-颞下入路锁孔手术治疗的5例原发性脑干出血的临床资料。结果 术后12 h内复查头颅CT显示所有血肿近完全清除；术后均出现高热、内环境紊乱等情况，经治疗后好转。术后未出现颅内感染等并发症。术后随访6个月，GOS评分4分1例，3分3例，2分1例。结论 对于脑干出血，早期手术清除血肿能改善病人的预后。耳前-颞下入路锁孔手术具有血肿清除彻底、创伤微小等优势，疗效满意。

Objective To investigate the clinical efficacy of keyhole surgery through preauricular-subtemporal approach for patients with primary brainstem hemorrhage.Methods The clinical data of 5 patients with primary brainstem hemorrhage who were treated with keyhole surgery through preauricular-subtemporal approach from February 2019 to April 2022 were retrospectively analyzed.Results Reexamination of head CT within 12 h after the operation showed that hematoma was almost completely evacuated in all the patients. High fever and internal environment disorder occurred in all the patients after the operation. There were no intracranial infection after the operation. The 6-month follow-up showed a GOS score of 4 in 1 patient, a GOS score of 3 in 3, and a GOS score of 2 in 1.Conclusions Early surgical removal of hematoma can improve the prognosis of patients with primary brainstem hemorrhage.Keyhole surgery through preauricular-subtemporal approach has the advantages of complete removal of hematoma, minimal trauma, and satisfactory curative effect.