经外侧裂入路治疗基底节脑出血的疗效分析

Efficacy analysis of Treatment of basal ganglia intracerebral hemorrhage by lateral fissure approach

目的探讨显微镜下经外侧裂入路血肿清除术治疗基底节脑出血患者对其神经功能与炎症因子水平的临床影响。方法选取驻马店市第一人民医院神经外科2020年6月—2021年6月收治的102例基底节脑出血患者作为研究对象,依据治疗术式分组,对照组(n=50)采取经皮层开颅血肿清除术,观察组(n=52)采取显微镜下经外侧裂入路血肿清除术,比较两组神经功能与炎症因子水平调节情况。结果与对照组相比,观察组手术时间、术后清醒时间与住院时间更短,出血量更少(P<0.05);两组血肿清除率比较差异无统计学意义(P>0.05);观察组癫痫、再出血、电解质紊乱、肺部感染发生率均明显低于对照组(P<0.05);与术前相比,两组术后肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)、高敏C反应蛋白(hs-CRP)及6-酮-前列腺素F1α(6-K-PGF1α)水平均明显降低,且观察组明显低于对照组(P<0.05);与术前相比,两组NIHSS评分明显降低,MBI评分明显提升,且观察组上述指标均明显优于对照组(P<0.05)。结论显微镜下经外侧裂入路血肿清除术治疗基底节脑出血可有效提高神经功能水平并降低炎症因子水平,有推广价值。

Objective To investigate the clinical effects of hematoma removal through lateral fissure approach under microscope on neurological function and inflammatory factors in patients with basal ganglia hemorrhage.Methods Totally 102 patients with basal ganglia intracerebral hemorrhage admitted to the Department of Neurosurgery of our hospital from June 2020 to June 2021 were selected as the research objects.They were divided into two groups according to the surgical treatment methods.The control group(n=50)received transcortical craniotomy hematoma removal,and the observation group(n=52)received microscopically translateral fissure hematoma removal.The regulation of nerve function and inflammatory factors were compared between the two groups.Results Compared with the control group,the operation time,postoperative awake time and hospitalization time in the observation group were shorter,and the blood loss was less(P<0.05).There was no significant difference in the clearance rate of hematoma between the two groups(P>0.05).The incidence of epilepsy,rebleeding,electrolyte disorder and pulmonary infection in observation group was significantly lower than that in control group(P<0.05).Compared with before operation,the levels of TNF-α,IL-4,hs-CRP and 6-K-PGF1α in 2 groups were significantly decreased after operation,and the observation group was significantly lower than the control group(P<0.05).Compared with before operation,NIHSS score of the two groups was significantly decreased,MBI score was significantly improved,and the above indicators in observation group were significantly better than control group(P<0.05).Conclusion Under microscope,hematomas removal through lateral fissure approach for basal ganglia cerebral hemorrhage can effectively improve the level of nerve function and reduce the level of inflammatory factors.