经外侧裂-岛叶入路与经颞叶皮质入路显微手术治疗基底节区脑出血的临床效果

Clinical Effect of Lateral Fissure-insular Lobe Approach and Transtemporal Cortex Approach Microsurgery in the Treatment of Basal Ganglia Intracerebral Hemorrhage

目的:分析经外侧裂-岛叶入路与经颞叶皮质入路显微手术治疗基底节区脑出血的临床效果。方法:选取2016年4月-2019年4月本院收治的40例基底节区脑出血患者作为研究对象,借助双盲随机法分为对照组、试验组,每组20例,对照组给予经颞叶皮质入路显微手术治疗,试验组给予经外侧裂-岛叶入路显微手术治疗。观察比较两组的治疗效果、血肿清除与骨瓣复位情况、围手术期情况、ALD评分与GCS评分及术后并发症发生情况。结果:试验组治疗总有效率高于对照组(P<0.05)。试验组手术时间、术后清醒时间均较对照组更短,术中出血量更少,差异均有统计学意义(P<0.05)。试验组血肿清除率和骨瓣复位率分别为95.00%、90.00%,较对照组的65.00%、60.00%高,差异均有统计学意义(P<0.05)。治疗前,两组ALD评分与GCS评分比较,差异均无统计学意义(P>0.05);治疗后,两组ALD评分与GCS评分均较治疗前升高,且试验组均高于对照组(P<0.05)。试验组术后并发症发生率为20.00%,较对照组的55.00%更低(P<0.05)。结论:基底节区脑出血患者予以经外侧裂-岛叶入路显微手术治疗具有显著优势,提升患者临床效果、血肿清除率、骨瓣复位率的同时,改善围手术期情况、减少术后并发症,提高ALD评分与GCS评分,值得临床进一步研究与采纳。

Objective:To analyze the clinical effect of lateral fissure-insular lobe approach and transtemporal cortex approach microsurgery in the treatment of basal ganglia intracerebral hemorrhage.Method:A total of 40 patients with basal ganglia intracerebral hemorrhage admitted to our hospital from April 2016 to April 2019 were selected as the research objects,they divided into control group and experimental group by double-blind random method,20 cases in each group.The control group was given transtemporal cortex approach microsurgery,the experimental group was given microsurgical treatment via the lateral fissure-island lobe approach.The therapeutic effect,hematoma clearance rate,bone flap reduction rate,perioperative conditions,postoperative complications,ALD score and GCS score were observed and compared between the two groups.Result:The total effective rate of the experimental group was higher than that of the control group(P<0.05).Compared with the control group,the operation time and postoperative waking time of the experimental group were shorter,the intraoperative blood loss was less,there were statistically significant differences(P<0.05).The hematoma clearance rate and bone flap reduction rate in the experimental group were 95.00%and 90.00%respectively,which were higher than 65.00%and 60.00%in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant difference in ALD scores and GCS scores between the two groups(P>0.05);after treatment,ALD score and GCS score of two groups were higher than those of before treatment,and the experimental group were higher than those of the control group(P<0.05).The incidence of postoperative complications in the experimental group was 20.00%,which was lower than 55.00%in the control group(P<0.05).Conclusion:For patients with cerebral hemorrhage in the basal ganglia region,microsurgical treatment via the lateral fissure-insular approach has significant advantages,can improve the clinical effect,hematoma clearance rate and bone flap reduction rate of the patients,the perioperative conditions can be improved,postoperative complications can be reduced,ALD score and GCS score can be improved,which is worthy of further clinical study and adoption.