经外侧裂岛叶入路手术治疗壳核出血的疗效观察  

Clinical effect of lateral fissure insula approach surgery on patients with putamen hemorrhage

作　　者：马淮滨 房勇 冯计富 

机构地区：[1]山东巨野煤田中心医院神经外科,巨野274900

出　　处：《中国实用神经疾病杂志》2015年第4期18-20,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的观察经外侧裂岛叶入路手术治疗壳核出血的临床效果。方法 80例壳核出血患者按照随机数字表法分为观察组和对照组。观察组采用经外侧裂岛叶入路手术,对照组采用经颞皮层造瘘手术。术后观察2组术中出血量、术后自动睁眼时间、住院时间及术后GCS评分。随访调查3a,分析2组病死率、ADL恢复良好率及术后并发症发生情况。结果术后发现,观察组患者术中出血量明显少于对照组(P<0.05),术后自动睁眼时间及住院时间明显短于对照组(P<0.05);术后GCS评分明显高于对照组(P<0.01)。观察组病死率明显低于对照组(χ2=4.500 6,P=0.033 9),ADL恢复良好率明显高于对照组(χ2=5.494 5,P=0.019 1)。术后再出血率、重度肺部感染及消化道溃疡大出血的发生率均明显低于对照组(P<0.05)。结论经外侧裂岛叶入路手术治疗壳核出血疗效显著,安全性高,值得临床推广应用。Objective To investigate the clinical effect of lateral fissure insula approach surgery on patients with putamen hemorrhage.Methods 80 patients with putamen hemorrhage were divided into control group（treated with the temporal cortex surgical approach）and observation group（treated with lateral fissure insula approach surgery）.The intraoperative blood loss,postoperative automatically open eyes and hospitalization time,and GCS scores of two groups were observed.The mortality rate,ADL good recovery rate and postoperative complications incidence of two groups were analyzed by follower-up 3 years.Results The intraoperative blood loss,postoperative automatically open eyes and hospitalization time,mortality rate,rebleeding rate,severe pulmonary infection and peptic ulcer bleeding incidence of observation group were lower than these of control group.The GCS scores,ADL good recovery rate of observation group were higher than these of control group.ConclusionLateral fissure insula approach surgery has significant effect and safety on patients with putamen hemorrhage,which is worthy of clinical application.

关 键 词：壳核出血 经外侧裂岛叶入路 经颞造瘘 脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]