经侧裂岛叶入路内镜辅助手术治疗优势侧基底节区高血压脑出血的临床疗效

Clinical Efficacy of Endoscopic-assisted Surgery Via Transsylvian Transinsular Approach in the Treatment of Hypertensive Intracerebral Hemorrhage in Dominant Basal Ganglia

目的观察经侧裂岛叶入路内镜辅助手术治疗优势侧基底节区高血压脑出血的临床疗效。方法选取2021年5月-2022年5月在我院诊治的40例优势侧基底节区高血压脑出血患者为研究对象,采用随机数字表法分为对照组(n=20)和观察组(n=20),对照组采用经颞叶切开显微镜术治疗,观察组采用经侧裂岛叶入路内镜辅助手术治疗,比较两组临床手术指标(手术时间、术中出血量)、血肿清除率、日常生活能力评定量表评分(ADL)、格拉斯哥预后评分(GOS)、波士顿诊断性失语症检查量表评分(BDAE)及并发症发生率。结果观察组手术时间、术中出血量均小于对照组(P<0.05);观察组血肿清除率为95.00%,高于对照组的80.00%(P<0.05);两组治疗后ADL评分、GOS评分均高于治疗前,且观察组高于对照组(P<0.05);观察组治疗后BDAE各维度(流畅、理解、复述、命名)评分均高于对照组(P<0.05);观察组并发症发生率(10.00%)低于对照组(25.00%)(P<0.05)。结论采用经侧裂岛叶入路内镜辅助手术治疗优势侧基底节区高血压脑出血效果良好,可提高血肿清除率,缩短手术时间,减少术中出血量,降低并发症发生率,减轻语言功能损伤,改善患者日常生活能力。

Objective To observe the clinical effect of endoscopic-assisted surgery via transsylvian transinsular approach in the treatment of hypertensive intracerebral hemorrhage in dominant basal ganglia.Methods Forty patients with hypertensive intracerebral hemorrhage in dominant basal ganglia diagnosed and treated in our hospital from May 2021 to May 2022 were selected as the research objects.They were divided into control group(n=20)and observation group(n=20)by random number table method.The control group was treated with temporal lobe incision microscopy,and the observation group was treated with endoscopic-assisted surgery via transsylvian transinsular approach.The clinical operation indexes(operation time,intraoperative blood loss),hematoma clearance rate,activity of daily living scale score(ADL),Glasgow outcome score(GOS),Boston diagnostic aphasia examination scale score(BDAE)and complication rate were compared between the two groups.Results The operation time and intraoperative blood loss in the observation group were less than those in the control group(P<0.05).The hematoma clearance rate of the observation group was 95.00%,which was higher than 80.00%of the control group(P<0.05).The ADL score and GOS score of the two groups after treatment were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).After treatment,the scores of BDAE dimensions(fluency,understanding,retelling,naming)in the observation group were higher than those in the control group(P<0.05).The incidence of complications in the observation group(10.00%)was lower than that in the control group(25.00%)(P<0.05).Conclusion Endoscopic-assisted surgery via transsylvian transinsular approach is effective in the treatment of hypertensive intracerebral hemorrhage in dominant basal ganglia,which can improve the hematoma clearance rate,shorten the operation time,reduce the intraoperative blood loss,reduce the incidence of complications,reduce the damage of language function,and improve the daily living ability of patients.