外侧裂入路手术治疗基底节区高血压脑出血的疗效分析

doi:10.3969/j.issn.1005-6483.2020.02.012

摘要/Abstract

摘要：

目的探讨外侧裂入路手术治疗基底节区高血压脑出血的临床效果。

方法 2014年10月～2018年6月在我院接受治疗的高血压基底节区脑出血病人82例，随机分为两组，对照组40例，接受经颞叶皮层入路手术。观察组42例，接受经外侧裂入路手术。比较两组病人的手术时间、术后24小时血肿清除程度、术后意识障碍、术后脑水肿情况及并发症发生情况和术后日常生活能力评价。

结果观察组手术时间略长于对照组，但差异无统计学意义（P＞0.05）。观察组血肿清除程度更高，治疗后7天内两组病人的GCS评分存在差异，观察组病人术后3天、5天、7天脑水肿程度明显轻于对照组，观察组术后并发症发生率为45.24%（19/42），对照组为67.5%（27/40），观察组病人的ADL评分在术后30天、90天和120天均明显优于对照组，差异有统计学意义（P<0.05）。

结论经外侧裂入路手术治疗基底节区高血压脑出血，手术时间略长，血肿清除效果好，术后脑水肿更轻，术后并发症少，功能恢复更好。

关键词: 外侧裂入路, 基底节区高血压脑出血, 生活能力

Abstract:

Objective To investigate clinical effect of surgical treatment through lateral fissure approach on hypertensive intracerebral hemorrhage in basal ganglia.

Methods Eighty two patients with hypertensive intracerebral hemorrhage in basal ganglia who were treated at the Second Affiliated Hospital of Shenyang Medical College from October 2014 to June 2018 were randomly divided into two groups，with 40 patients in the control group and 42 patients in the observation group.Patients in the observation group were treated with a surgery through lateral fissure approach，and patients in the control group were given a surgery through the cortex of temporal lobe.The surgery time， the degree of hematoma clearance，Glasgow Coma Scale（GCS）， postoperative cerebral edema，complications and daily living ability scale（ADL）were compared between the two groups.

Results The surgery time of the observation group was slightly longer than that of the control group，but the difference was not statistically significant（P＞0.05）.The degree of hematoma clearance was better in the observation group（P<0.05）.After treatment，the GCS scores of the two groups were significantly different within 7 days（P<0.05）.The degree of cerebral edema of the observation group was significantly lighter than that of the control group at 3 days，5 days，and 7 days after surgery（P<0.05）.The postoperative complication rate was 45.24%（19/42）in the observation group，which was significantly lower than that in the control group（67.5%，27/40）（P<0.05）.The ADL scores of the observation group were significantly higher than the control group at 30 days，90 days and 120 days after surgery（P<0.05）.

Conclusion A surgery through lateral fissure approach for the treatment of hypertensive intracerebral hemorrhage in basal ganglia，is associated with slightly longer surgery time，better effect of hematoma clearance，slighter postoperative cerebral edema，fewer postoperative complications，and better functional recovery，is worthy of clinical promotion.

Key words: lateral fissure approach, hypertensive intracerebral hemorrhage in basal ganglia, postoperative living ability

隋宇玲. 外侧裂入路手术治疗基底节区高血压脑出血的疗效分析[J]. 临床外科杂志, 2020, 28(2): 137-139.

SUI Yuling.. Clinical analysis of lateral fissure approach in the treatment of hypertensive intracerebral hemorrhage in basal ganglia region[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(2): 137-139.

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