经外侧裂岛叶入路清除颅内血肿治疗高血压基底节区脑出血临床价值分析

Surgery through transsylvian-transinsular approach in treatment of hypertensive basal ganglia hematoma

目的 对比分析经外侧裂岛叶入路与经颞叶皮质入路清除颅内血肿治疗高血压基底节区脑出血的临床效果.方法 选取2015年3月至2016年3月本院收治的60例高血压基底节区脑出血患者作为研究对象,随机平均分为观察组和对照组,其中观察组接受经外侧裂岛叶入路手术治疗（30例）,对照组接受经颞叶皮质入路手术治疗（30例）.回顾性分析两组手术时间、术后颅内血肿清除情况及预后情况.结果 观察组手术时间短于对照组,差异有统计学意义（P＜0.05）;观察组血肿清除率高于对照组（P＜0.05）,但术后再出血差异无统计学意义（P＞0.05）;术后随访,观察组预后良好率（73.4％）高于对照组（36.6％）,两组差异有统计学意义（P＜0.05）.结论 经外侧裂岛叶入路手术治疗高血压基底节区脑出血能有效清除血肿,减少术后再出血的发生,显著改善预后.

Objective To explore the clinical efficacy of surgery through transsylvian-transinsular approach versus transcortical-transtemporal approach in the treatment of hypertensive basal ganglia hematoma.Methods 60 patients with hypertensive basal ganglia hematoma treated at our hospital from March,2015 to March,2016 were selected and divided into an observation group （through transsylvian-transinsular approach,30 cases） and a control group （through transcortical-transtemporal approach,30 cases）.The removal volumes of intracranial hematoma and prognosis were compared between these two groups.Results The operation time was shorter in the observation group than in the control group （P〈0.05）.The postoperative removal rate of hematoma was higher in the observation group than the control group,with a statistical difference （P〈0.05）.There was no statistical difference in rebleeding rate between these two groups （P〉0.05）.The rate of good prognosis was 73.4% in the observation group and 36.6% in the control group （P〈0.05）.Conclusions Surgery through transsylvian-transinsular approach is an effective treatment for hypertensive basal ganglia hematoma and is characterized by higher hematomas removal rate,lower rebleeding rate,and good recovery of nervous function.