高血压脑出血的临床特点及经翼点入路小骨窗经岛叶手术治疗的临床效果研究

Clinical Characteristics of Hypertensive Intracerebral Hemorrhage and the Clinical Effect of Transpterional Approach through Small Bone Window and Transinsular Surgery

目的对高血压脑出血临床特点进行分析,并探究经翼点入路小骨窗经岛叶手术在其治疗中的作用效果。方法按照随机抽样方法抽取该院2018年3月—2020年3月期间收治的高血压脑出血患者开展研究,选取70例,经不同手术方式分为A组(传统开颅手术)、B组(经翼点入路小骨窗经岛叶手术),现分析高血压脑出血患者临床特点(出血量、出血部位、神经功能缺损等),并比较两组治疗效果、并发症情况。结果所有患者多数情况下表现出偏瘫,且GCS评分、神经功能缺损评分分别为6~9分、16~30分,同时基底节区易出血,出血量为30~60 mL。B组总有效率(94.29%)高于A组(71.43%),比较差异有统计学意义(χ^(2)=6.437,P=0.011);B组术后并发症发生率(8.57%)低于A组(28.57%),比较差异有统计学意义(χ^(2)=4.629,P=0.031);B组KPS评分高于A组,比较差异有统计学意义(t=12.036,P=0.001)。结论高血压脑出血发生后,容易发生偏瘫、失语、认知障碍,且基底节区是高发出血部位,约为30~60 mL,预后较差。在实践中采取经翼点入路小骨窗经岛叶手术,疗效确切,安全可靠,值得优选。

Objective To analyze the clinical characteristics of hypertensive intracerebral hemorrhage,and to explore the effect of transpterional small bone window transinsular surgery in its treatment.Methods According to the random sampling method,a study of patients with hypertensive cerebral hemorrhage admitted to the hospital from March 2018 to March 2020 was carried out.70 cases were randomly selected,and they were divided into group A(traditional craniotomy)and group B(transpterional approach through small bone window transinsular surgery),the clinical characteristics of patients with hypertensive intracerebral hemorrhage(bleeding volume,bleeding site,neurological deficit,etc.)were analyzed,and the treatment effects and complications of the two groups were compared.Results All patients showed hemiplegia in most cases,and the GCS score and neurological deficit score were 6-9 points and 16-30 points,respectively.At the same time,the basal ganglia area was prone to bleeding,and the amount of bleeding was 30-60 mL.The total effective rate of group B(94.29%)was higher than that of group A(71.43%),and the difference was statistically significant(χ^(2)=6.437,P=0.011);the postoperative complication rate of group B(8.57%)was lower than that of group A(28.57%),the difference was statistically significant(χ^(2)=4.629,P=0.031);the KPS score of group B was higher than that of group A,and the difference was statistically significant(t=12.036,P=0.001).Conclusion After hypertensive intracerebral hemorrhage occurs,hemiplegia,aphasia,and cognitive impairment are prone to occur,and the basal ganglia is the site of high blood emission,about 30-60 mL,and the prognosis is poor.In practice,the transpterional approach through the small bone window and transislandolobe surgery is effective,safe and reliable,and it is worthy of optimization.