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目的 探讨治疗基底节脑出血三种手术人路的操作技巧及疗效.方法 高血压基底节脑出血病人197例,根据临床表现及CT检查等,分别采取3种入路手术.32例侧裂前型血肿经额入路手术清除,76例侧裂中心型血肿经侧裂入路手术清除,89例侧裂后型血肿经颞叶人路手术清除.结果 术后复查CT显示,145例血肿基本清除.术后再出血7例,死亡18例.139例术后随访,根据日常生活活动能力(ADL)评价预后,良好116例(1～3级),其中1级35例,2级57例,3级24例;23例预后较差(4～5级).结论 3种入路各有适应证,具体采用哪种入路需要根据病人的出血位置来决定.“,”Objective To explore the microsurgical treatment of the hypertensive basal ganglia hemorrhage through three approaches and curative effect on it.Methods Neurosurgery through the individualized approach was performed in 197 patients with hypertensive basal ganglia hemorrhage.The hematomas in the anterior lateral prefissure were evacuated by the neurosurgery through the frontal approach in 32 patients.The hematomas in the lateral fissure centers were evacuated by the neurosurgery through the lateral fissure approach in 76 patients.The hematomas in the posterior lateral fissure were evacuated by the neurosurgery through the temporal approach in 89 patients.Results Postoperative CT scanning showed that hematomas were evacuated mainly in 145 patients.The rebleeding occurred in 7 patients and 18 patients died after the operation.The following up 6 months after the operation showed that 116 patients(a total of 139 cases) were recovered well(grade 1 to 3)according the activities of daily life (ADL),among them,35 cases in grade 1,57 cases in grade 2,24 cases in grade 3.The prognosis of 23 cases was poor (grade 4 to 5).Conclusion The surgical approaches should be selected according to the hematoma position.It is best to remove hematoma totally,stop the bleeding strictly and avoid secondary lesion.