超早期小翼点切口锁孔经侧裂-岛叶入路显微手术治疗高血压基底节区脑出血临床观察  

Clinical observation of ultra-early lateral fissure insula approach microsurgery via small pterional keyhole incision for the treatment of hypertensive basal ganglia hemorrhage

作　　者：周建军[1] 官测林 胡方进[1] 卢靖[1] 郭东斌[1] 

机构地区：[1]福建医科大学附属龙岩市第一医院神经外科,龙岩364000

出　　处：《中国实用神经疾病杂志》2016年第24期7-9,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的观察超早期小翼点切口锁孔经侧裂-岛叶入路显微手术治疗高血压基底节区脑出血的临床疗效。方法80例高血压基底节脑出血患者随机分为实验组和对照组,实验组采用超早期小翼点切口锁孔经侧裂-岛叶入路显微手术治疗,对照组采用经颞顶瓣或额顶瓣开颅血肿清除术治疗。比较2组血肿清除效果、术后生活质量及术后并发症发生情况。结果实验组术后48h内血肿大部分清除率(血肿清除≥90%+彻底清除)显著高于对照组,生活质量优良率显著高于对照组,术后消化道出血、腹泻、肺部感染、再出血、泌尿系统感染等并发症发生率显著低于对照组,差异均有统计学意义(P<0.05)。结论超早期小翼点切口锁孔经侧裂-岛叶入路显微手术较传统骨瓣开颅血肿清除术可减少对脑组织的损伤,创伤小,术后并发症发生率低,明显改善患者预后,提高患者生活质量,值得临床推广应用。Objective To observe the clinical effect of ultra-early lateral fissure insula approach microsurgery via small pterional keyhole incision for the treatment of hypertensive basal ganglia hemorrhage （HBGH）. Methods Eighty patients with HBGH were randomly divided into experimental group and control group,and the former was treated by ultra-early lateral fissure insula approach microsurgery via small pterional keyhole incision while the later received craniotomy and evacuation of hematoma via temporoparietal or frontoparietal approach. Then the effect of evacuation of hematoma,postoperative quality of life and complications were compared between two groups. Results Within 48h after operation,the clearance rate of large part of hematoma （the clearance rate ≥90% or thorough clearance）in the experimental group was significantly higher than that in the control group （P〈0.05）. And compared with the control group,the experimental group showed more improvement as for the favorable rate of the quality of life （P〈0.05）and had lower occurrence rate of postoperative complications such as gastrointestinal bleeding,diarrhea,pulmonary infection,re-bleeding and urinary system infection （P〈0.05）. Conclusion Ultra-early lateral fissure insula approach microsurgery via small pterional keyhole incision which can reduce the injury for brain tissues,lower occurrence rate of postoperative complications,improve prognosis and enhance quality of life with small trauma,may be worthy of clinical applications.

关 键 词：小翼点 侧裂-岛叶 显微手术 高血压脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]