微创手术对高血压基底节脑出血患者颅内感染风险及神经功能恢复的影响

Effects of minimally invasive surgery on the risk of intracranial infection and recovery of nerve function in patients with hypertensive basal ganglia intracerebral hemorrhage

目的研究微创手术对高血压基底节脑出血患者颅内感染风险及神经功能恢复的影响。方法选取2015年1月至2020年12月本院收治的56例高血压基底节脑出血患者作为研究对象,根据治疗方法的不同将其分为对照组与观察组,每组28例。对照组给予经颞叶皮质造瘘血肿清除术,观察组给予经侧裂-岛叶入路显微手术。比较两组的围术期相关指标、血管内皮功能指标、格拉斯哥昏迷评分法(GCS)评分、Karnofsky功能状态(KPS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、临床疗效、并发症发生情况。结果观察组的术中出血量、手术时间、平均血肿清除率、术后意识恢复时间、住院时间均优于对照组,差异具有统计学意义(P<0.05)。术后,两组的ET-1水平降低,NO水平升高,且观察组优于对照组,差异具有统计学意义(P<0.05)。术后,两组的GCS、KPS评分升高,NIHSS评分降低,且观察组优于对照组,差异具有统计学意义(P<0.05)。观察组的治疗总有效率为96.43%,高于对照组的75.00%,差异具有统计学意义(P<0.05)。观察组的并发症总发生率为7.14%,低于对照组的28.57%,差异具有统计学意义(P<0.05)。结论经侧裂-岛叶入路显微手术治疗高血压基底节脑出血患者的效果显著,且可改善血管内皮功能和神经功能,改善预后,降低并发症发生率,值得临床推广应用。

Objective To study the effects of minimally invasive surgery on the risk of intracranial infection and recovery of nerve function in patients with hypertensive basal ganglia intracerebral hemorrhage.Methods A total of 56 patients with hypertensive basal ganglia intracerebral hemorrhage treated in our hospital from January 2015 to December 2020 were selected as the research objects.The patients were divided into control group and observation group according to different treatment methods,with 28 cases in each group.The control group was treated with transtemporal lobe for cortical fistula hematoma removal,and the observation group was treated with microsurgery via lateral fissure-insular approach.The perioperative related indexes,vascular endothelial function indexes,Glasgow coma scale(GCS)score,Karnofsky functional state(KPS)score,national institutes of health stroke scale(NIHSS)score,clinical efficacy and complications were compared between the two groups.Results The amount of intraoperative bleeding,operation time,average hematoma clearance rate,postoperative consciousness recovery time and hospital stay in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).After operation,the level of ET-1 decreased in the two groups,the level of NO increased,those in the observation group were better than the control group,and the differences were statistically significant(P<0.05).After operation,the GCS and KPS scores in the two groups increased,and the NIHSS score decreased,those in the observation group were better than the control group,and the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 96.43%,which was higher than 75.00% in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was 7.14%,which was lower than 28.57% in the control group,and the difference was statistically significant(P<0.05).Conclusion Microsurgery via lateral fissure-insular approach in the treatment of patients with hypertensive basal ganglia intracerebral hemorrhage has a significant effect,it can improve vascular endothelial function,nerve function and the prognosis,and reduce the incidence of complications,which is worthy of clinical promotion and application.