高血压自发性脑出血侧裂入路手术近期疗效及并发症分析

Short-term curative effect and complications of lateral fissure approach surgery in hypertensive spontaneous intracerebral hemorrhage

目的分析侧裂入路手术治疗高血压自发性脑出血的近期疗效及并发症情况。方法2013年6月-2016年1月行侧裂入路手术的54例高血压自发性脑出血患者为治疗组，选择同期行颢叶皮质入路手术的50例高血压自发性脑出血患者为对照组，比较两组围术期相关指标、血肿清除率、术后并发症及术后6个月预后情况。结果平均手术时间、术中出血量、术后意识恢复时间方面，治疗组均明显少于对照组（P〈0．05）；血肿清除方面，治疗组血肿清除〉90%比率70．37％显著高于对照组的50．00％（P〈0．05）；治疗组并发症发生率7．40％显著低于对照组的30．00％（P〈0．05）；治疗组术后6个月预后良好率70．37％显著高于对照组的42．00％，差异有统计学意义（P〈0．05）。结论相比颞叶皮质入路手术，侧裂入路显微手术治疗高血压自发性脑出血具有创伤小、血肿清除率高、术后并发症少、近期预后良好特点。

Objective To analyze the short-term curative effect and complications of lateral fissure approach surgery in hypertensive spontaneous intracerebral hemorrhage. Methods Fifty- four patients with hypertensive spontaneous intracerebral hemorrhage treated by lateral fissure approach surgery between June 2013 and January 2016 were enrolled in the treatment group. Another 50 patients with hypertensive spontaneous intracerebral hemorrhage treated by temporal lobe cortex approach surgery were enrolled in the control group. The perioperative related indexes,clearance rate of hematoma, postoperative complications and prognosis in postoperative 6 months were compared between the two groups. Results The average operation time,intraoperative blood loss and postoperative consciousness recovery time of treatment group was significantly less and shorter than control group （P〈0.05） ; The ratio of clearance rate of hematoma ：〉 90% in treatment group （70.37%） was significantly higher than control group （50.00%） （P〈0.05） ; The incidence rate of complication in treatment group （7.40%） was significantly lower than control group （30.00%） （P〈0.05） ; The rate of excellent and good prognosis in postoperative 6 months in treatment group （70.37%） was significantly higher than control group （42.00%） （P d0.05）. Conclusion Compared with temporal lobe cortex approach surgery, the lateral fissure approach microsurgery is with characteristics of minimally invasive, high clearance rate of hematoma, fewer postoperative complications and good short-term prognosis in the treatment of hypertensive spontaneous intracerebral hemorrhage.