经额部和经颞部入路导航辅助下内镜手术治疗高血压性基底节区出血的对比分析  

Neuroendoscopic surgery under neuronavigation guidance for hypertensive basal ganglia hemorrhage:frontal appraoch vs. temporal approach

作　　者：阮航[1] 杨国平[1] 罗明[1] 段发亮[1] 闵强[1] 张严国[1] 

机构地区：[1]武汉市第一医院神经外科,430022

出　　处：《中国临床神经外科杂志》2017年第10期693-694,697,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的比较经额部和经颞部入路导航辅助下内镜手术治疗高血压性基底节区出血的临床疗效。方法回顾性分析2011年1月至2016年6月导航辅助下内镜手术治疗的60例高血压性基底节区出血的临床资料,28例采用经额入路(经额组),32例采用经颞入路(经颞组)。术后3个月采用GOS评分评估预后。结果经额组手术时间[(83±27)min]和经颞组手术时间[(81±30)min]无显著差异(P>0.05)。经额组血肿清除率[(88±11)%]明显高于经颞组[(79±19)%;P<0.05]。经额组预后良好率(67.86%;GOS评分4~5分)明显高于经颞组(40.63%;P<0.05)。结论神经导航辅助下内镜手术治疗高血压性基底节区出血时,经额入路相对于经颞入路可以提高血肿清除率,改善预后,是较优的手术入路。Objective To explore the clinical effects of neuroendoscopic surgery via frontal approach and temporal approach under neuronavigation guidance on hypertensive basal ganglia hemorrhage(HBGH). Methods The clinical data of 60 patients with HBGH, of whom, 28 underwent neuroendoscopic surgery via frontal approach(frontal group) under neuronavigation guidance and 32 via temporal approach(temporal group) from January, 2011 to June, 2016, were analyzed retrospectively. Results There was no significant difference in the operation duration between both the frontal group [(83±27) min] and temporal group [(81±30) min](P>0.05). The rate of hematoma evacuation and good prognosis were significantly higher in frontal group [(88±11)% and 67.8% respectively] than those in temporal group [(79 ± 19)% and 40.63% respectively](P<0.05). Conclusions The rate of hematoma evacuation can be enhanced and the prognosis can be improved by neuroendoscopic surgery via the frontal approach under neuronavigation guidance in the patients with HBGH 3 months after the operation.

关 键 词：高血压性脑出血 基底节 神经导航 神经内镜 手术 经额入路 经颞入路 疗效 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]