不同手术入路对脑出血病人语言功能的保护作用

PROTECTIVE EFFECT OF DIFFERENT OPERATIVE APPROACHES ON LANGUAGE FUNCTION IN PATIENTS WITH CEREBRAL HEMORRHAGE

目的比较不同手术入路对左侧基底核区脑出血病人语言功能的影响。方法将高血压脑出血病人按不同的手术入路分为两组,其中经侧裂-岛叶入路手术组（A组）32例,皮质造瘘手术组（B组）28例,评价两组病人术后日常生活能力及失语程度。结果 A组日常生活能力评分优于B组（u=322.00,P〈0.05）,失语严重程度较B组轻（u=314.50,P〈0.05）。A组流畅、命名得分高于B组,复述得分低于B组,差异有显著性（t=3.327～7.207,P〈0.01）;两组理解得分比较差异无显著性（P〉0.05）。结论经侧裂-岛叶入路清除血肿可在一定程度上减轻基底核脑出血病人的失语症状,效果优于皮质造瘘清除血肿。

Objective To compare the effect of different operative approaches on language function in patients with left basal ganglia intracerebral hemorrhage. Methods Patients with hypertensive intracerebral hemorrhage were divided into two groups according to different operative approaches.Group A（32cases）,sylvian fissure approach was used;Group B（28cases）,cortical fistula was adopted.Postoperative activity of daily living and the extent of aphasia of patients in the two groups were evaluated. Results The score of activity of daily living was higher in group A versus group B（u=322.00,P〈0.05）,and the severity of aphasia was lower（u=314.50,P〈0.05）.In group A,the score of fluency and naming was higher than that in group B,and that of repeat was lower,the differences being significant（t=3.329-7.207,P〈0.01）.As for the score of＂understanding＂,the diffe-rence between the two groups was not significant（P〉0.05）. Conclusion Hematoma elimination through sylvian fissureinsula approach can,to a certain degree,improve symptom of aphasia in patients with left basal ganglia hemorrhage,the effectiveness is better than cortical fistula plus hematoma removal.