经外侧裂-岛叶与颞叶上回入路清除基底节区出血的疗效对比分析

Comparative study on transsylvian fissure-insular approach and transsuperior temporal gyrus approach for removal of intracerebral hemorrhage in basal ganglia region

目的分析经外侧裂-岛叶入路清除高血压基底节区脑出血的疗效。方法回顾分析49例单纯基底节区内囊以外的血肿患者,其中经外侧裂-岛叶入路显微手术治疗21例,经颞叶皮质入路手术治疗28例。从手术方法、血肿暴露、血肿清除难易、术中止血、术中脑组织损伤、术后复查、患者恢复方面进行对比分析。结果经外侧裂-岛叶与经颞上回入路清除高血压基底节区脑出血组比较,在72 h再出血率及术后3个月日常生活能力评分(ADL)中的Barthel指数评分比较,差异有统计学意义(均P<0.05)。结论经外侧裂-岛叶入路清除高血压基底节区脑出血的效果优于经颞上回入路。

Objective To analysis the efficacy of transsylvian fissure-insular surgical approach for removal of intracerebral hematoma in basal ganglia region. Methods The clinical datas of 21 patients underwent microsurgery by transsylvian fissure-insular surgical approach and 28 by transsuperior temporal gyrus approach were analyzed retrospectively. Results There were significant differences of the recurrent hemorrhage rate,the Barthel index after3 months between two groups（ P〈0. 05）. Conclusion Transsylvian fissure-insular approach is safer and more effective than transsuperior temporal gyrus approach in the treatment of hypertensive intracerebral hemorrhage in basal ganglia region.