摘要
目的探究外侧裂-岛叶入路对基底节出血患者的神经功能预后及炎性因子水平的影响。方法将基底节出血患者随机分组,52例对照组患者采用颞叶皮层手术入路,观察组85例患者采用外侧裂-岛叶手术入路,比较2组患者的手术时间和血肿清除率;治疗3、7和14 d后用NIHSS评分和GCS评分评价2组患者的恢复情况;治疗14 d后检测患者血清中CRP、TNF-α、IL-6及IL-8水平;2组发生不良反应的情况;治疗90 d后随访,比较2组的长期预后。结果观察组患者的手术时间短于对照组,且观察组患者血肿清除率>90%的患者比例明显高于对照组(P<0.05);治疗7 d后观察组患者NIHSS评分和GCS评分优于对照组(P<0.05);观察组患者的炎性因子指标恢复也明显优于对照组(P<0.05);2组不良反应比较无明显差异(P>0.05);2组患者发病90 d后随访显示观察组患者的NIHSS评分优于对照组(P<0.05)。结论外侧裂-岛叶入路可改善基底节出血患者的神经功能预后,有效改善体内炎性因子的表达水平。
Objective To investigate the effects of the transsylvian-transinsular microsurgery on the neurological deficit recovery and inflammatory factor levels in patients with basal ganglia hemorrhage. Methods 137 patients with basal ganglia hemorrhage were collected in this study. 52 patients in control group were treated with transtemporal cortex approach, and 85 patients in observation group were treated with the trans- sylvian-transinsular approach. The operation time and the rate of hematoma clearance were compared between two groups. NIHSS score and GCS score were used to evaluate the recovery of patients after 3, 7 and 14 days. The CRP,TNF-α,IL-6 and IL-8 levels were detected after 14 days, and the adverse reactions were recorded in two group, follow up was performed at 90th day after treatment. Results The operation time of the observa- tion group was shorter than that of the control group, and the number of hematoma clearance rate 〈90% in the observation group was significantly higher than that in the control group （P〈0.05）, at 7th day after treat- ment, the N1HSS score and GCS score of patients in the observation group was better than those in the control group （P〈0. 05） ; inflammatory factor level detection showed that the level of the observation group was sig nificantly better than that of the control group （P〈0. 05）, there was no significant difference in adverse reac- tions between two groups （P〈0. 05）, NIHSS score of the observation group was better at 90th day after treat- ment than that of the control group and the difference was statistically significant （P〈0. 05）. Conclusion transsylvian-transinsular approach could effectively improve the neural function and reduce the inflammatory reaction in basal ganglia hemorrhage patients.
作者
王星
隗麟懿
Wang Xing;Wei Linyi(Department of Neurosurgery,Dazhou Central Hospital of Sichuan 63500)
出处
《卒中与神经疾病》
2018年第4期424-426,460,共4页
Stroke and Nervous Diseases
关键词
外侧裂-岛叶入路
颞叶皮层入路
基底节
脑出血
Transsylvian-transinsular
Transtemporal cortex
Ganglioside
Cerebral hemorrhage
