颞下经小脑幕入路显微手术治疗高血压脑干出血的临床效果

Clinical effect of infratemporal transtentorial microsurgery in the treatment of hypertensive brainstem hemorrhage

目的探讨颞下经小脑幕入路手术治疗高血压脑干出血的临床效果。方法选取2018年1月至2021年3月江西省人民医院收治的50例高血压脑干出血患者作为研究对象,按照随机数字表法将其分为对照组与研究组,每组各25例。对照组患者应用保守治疗方法,研究组患者应用颞下经小脑幕入路手术治疗方法。比较两组患者的死亡率、并发症发生率、住院时间、治疗3周后的美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥预后评分(GOS)以及治疗效果。结果研究组患者的死亡率、并发症发生率均低于对照组,差异有统计学意义(P<0.05)。研究组患者的住院时间短于对照组,NIHSS评分低于对照组,GOS评分高于对照组,差异有统计学意义(P<0.05)。研究组患者的治疗总有效率为88.0%,高于对照组的68.0%,差异有统计学意义(P<0.05)。结论相较于保守治疗,高血压脑干出血患者应用颞下经小脑幕入路手术治疗的效果较好,可以有效提高治疗效果,降低患者发生并发症的概率以及死亡率,同时可以改善患者的神经功能缺损情况和预后效果,缩短其住院时间,值得推广应用。

Objective To investigate the clinical effect of subtemporal transtentorial approach in the treatment of hypertensive brainstem hemorrhage.Methods Fifty patients with hypertensive brainstem hemorrhage admitted to Jiangxi Provincial People′s Hospital from January 2018 to March 2021 were selected as the research objects and divided into the control group and the research group according to the random number table method,with 25 cases in each group.The control group was treated with conservative treatment,while the study group was treated with subtemporal transtentorial approach.The complication rate,mortality,hospital stay,National Institutes of Health scale score(NIHSS),Glasgow outcome score(GOS)and treatment effect were compared between the two groups.Results The mortality and complication rates of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).The hospital stay of the study group was shorter than that of the control group,the NIHSS score was lower than that of the control group,the GOS score was higher than that of the control group,the differences were statistically significant(P<0.05).The total effective rate of the study group was 88.0%,which was higher than that of the control group(68.0%),and the difference was statistically significant(P<0.05).Conclusion Compared with conservative treatment,the treatment effect of infratemporal transtentorial approach in patients with hypertensive brainstem hemorrhage is better,which can effectively improve the treatment effect,reduce the risk of complications and mortality,and improve the neurological functional impairment and prognostic effect,shortening the length of hospital stay,it is worth popularizing and applying.