显微镜下微创经侧裂-岛叶基底节区高血压脑出血手术的疗效分析

Analysis of the efficacy of microscopic minimally invasive surgery to treat hypertension cerebral hemorrhage in the basal ganglia region through the lateralfissure -insular approach

目的探讨显微镜下微创经侧裂-岛叶行血肿清除手术治疗急性期高血压脑出血的临床疗效。方法采用随机数字表法将我院收治的66例高血压脑出血手术患者分为2组，每组33例。A组患者采用显微镜下微创经侧裂-岛叶手术清除血肿，B组患者采用传统经颞叶切开皮质清除血肿＋去骨瓣减压术。比较2组患者术中出血量、手术时间、住院时间、术后相关并发症发生率、日常生活能力量表（ADL）评分及神经功能缺损评分（NIHSS）情况。结果A组ADL评分及NIHSS评分明显高于B组（P〈0．05）。A组术中出血量、手术时间和住院时间均少于B组（P〈0.05）。A组患者术后并发症发生率明显低于B组（P〈0．05）。结论显微镜下微创经侧裂-岛叶手术治疗高血压脑出血临床效果良好，可较明显改善患者的预后，值得临床推广应用。

Objective To discuss the efficacy of microscopic minimally invasive surgery to treat hypertension cerebral hemorrhage through the lateral fissure - insular approach. Methods A total of 66 patients with hypertensive cerebral hemorrhage who were admitted to our hospital were randomly divided into Groups A and B （ n = 33 ）. Group A were treated by microscopic minimally invasive surgery through the lateral fissure - insular approach. Group B were treated by traditional craniotomy. Then, both groups were compared for intraoperative blood loss, operation time, hospitalization stay, the incidence of postoperative complications, activity of daily living （ADL） Scale scores and the National Institutes of Health Stroke Scale （NIHSS） scores. Results Group A showed remarkable higher ADL and NIHSS scores than Group B （P 〈 0.05）. Compared with Group B, marked decreases were found in intraoperative blood loss, operation time, hospitalization stay and postoperative complication incidence （ P 〈 0.05 ）. Conclusions Through the lateral fissure - insular approach, microscopic minimally invasive surgery can treat hypertension cerebral hemorrhage and improve prognosis.