摘要
目的探讨外侧裂-岛叶入路和额中回皮质入路对高血压基底节脑出血(hypertensive basal ganglia hemorrhage,HBGH)患者的血肿清除效果。方法选取2019-10至2022-01在北京昌平医院手术的108例HBGH患者,按手术方案不同分为两组,每组54例。对照组采用侧裂-岛叶入路血肿清除术,观察组采用额中回入路血肿清除术,对两组患者的手术时间、苏醒时间、血肿清除率及术后3个月格拉斯哥预后评分(Glasgow outcome scale,GOS)进行对比分析。结果观察组血肿清除率为91.63%±0.77%,高于对照组(82.82%±2.62%),差异有统计学意义(P<0.05),且手术时间、术中出血量、手术后并发症发生率、住院时间均显著优于对照组,差异有统计学意义(P<0.05);观察组患者术后3个月的GOS评分显著高于对照组,差异有统计学意义(P<0.05)。结论HBGH患者采用经额中回入路清除血肿,血肿清除率高,可缩短手术时间,改善患者神经功能预后。
Objective To compare the hematoma removal effect of trans-sylvian insular approach and ventriculostomy through middle frontal gyrus approach in hypertensive basal ganglia hemorrhage(HBGH)patients.Methods One hundred and eight patients with HBGH treated in Beijing Changping Hospital from October 2019 to January 2022 were divided into two groups according to surgical treatments,with 54 cases underwent trans-sylvian insular approach(control group)and ventriculostomy through middle frontal gyrus approach(observational group),respectively.The operation time(OT),postoperative recovery time(PRT),hematoma clearance rate(HCR),operation-related complication(ORC),and Glasgow Outcome Scale(GOS)3 months after surgery of the two groups were compared.Results The hematoma clearance rate in the observational group was 91.63%±0.77%,which was significantly higher than that in the control group(82.82%±2.62%)(P<0.05).The cases with operation time,intraoperative bleeding loss,operation-related complication,and hospital staying of the observation group were significantly lower than those of the control group,while GOS 3 months after surgery were significantly higher than that of the control group(P<0.05).Conclusion The ventriculostomy through middle frontal gyrus approach is more convenient than trans-sylvian insular approach in hematoma removal of HBGH patients,especially in shortening operation,reducing postoperative complication,and improving hematoma effect and neurological prognosis.
作者
孙剑
洪顺明
杜海斌
李建强
SUN Jian;HONG Shunming;DU Haibin;LI Jianqiang(Department of Neurosurgery,Beijing Changping District Hospital,Beijing 100020,China;Department of Neurosurgery,the Third Medical Center of PLA General Hospital,Beijing 100039,China)
出处
《武警医学》
CAS
2022年第7期590-593,共4页
Medical Journal of the Chinese People's Armed Police Force
关键词
额中回入路
侧裂岛叶入路
高血压基底节脑出血
血肿清除术
微创
ventriculostomy through middle frontal gyrus approach
trans-sylvian insular approach
hypertensive basal ganglia hemorrhage
hematoma evacuation
minimally invasive
作者简介
孙剑,硕士,副主任医师。
