经侧裂入路显微手术治疗基底节区高血压脑出血的临床体会  

Clinical experience of microsurgery via lateral fissure approach in the treatment of basal ganglia hypertensive cerebral hemorrhage

作　　者：王坤[1] 李冰[1] 赵鹏[1] 刘光磊[1] 陈建勇[1] 刘东伟[1] 袁萍 

机构地区：[1]青岛市黄岛区人民医院神经外科,266400 [2]青岛市黄岛区妇幼保健一中心

出　　处：《中国实用医药》2017年第32期1-3,共3页China Practical Medicine

基　　金：青岛西海岸新区优秀青年人才培养计划(项目编号:青黄组[2015]18号)

摘　　要：目的对基底节区高血压脑出血采用经侧裂入路显微手术治疗的效果进行探讨。方法选取37例给予经皮层进入血肿腔进行显微手术的基底节区高血压脑出血患者作为对照组,另选取37例给予经侧裂入路进入血肿腔进行显微手术治疗的基底节区高血压脑出血患者作为观察组,对两组患者治疗效果及术后并发症发生情况进行对比。结果两组患者术后并发症主要包括继发性癫痫、再次出血、气颅、感染等,观察组并发症发生率为32.43%,明显低于对照组的75.68%,差异具有统计学意义(P<0.05)。观察组患者日常生活能力(ADL)分级情况明显优于对照组,差异具有统计学意义(U=2.008,P<0.05);观察组患者的死亡率(2.70%)明显低于对照组(16.22%),差异具有统计学意义(P<0.05)。结论对基底节区高血压脑出血患者采用经侧裂入路显微手术方法进行治疗,术后并发症较少,更加符合微创理念,可显著降低患者脑细胞损伤,疗效确切,在临床中值得推广。Objective To investigate the effect of microsurgery via lateral fissure approach in the treatment of basal ganglia hypertensive cerebral hemorrhage. Methods A total of 37 basal ganglia hypertensive cerebral hemorrhage patients underwent microsurgery via the cortex into the hematoma cavity were selected as the control group, and another 37 basal ganglia hypertensive cerebral hemorrhage patients underwent microsurgery via lateral fissure approach as the observation group. Comparison were made on treatment effect and occurrence of postoperative complications between two groups. Results The postoperative complications of the two groups mainly included secondary epilepsy, recurrent bleeding, pneumocrania and infection. The observation group had obviously lower incidence of complications as 32.43% than 75.68% in the control group, and the difference was statistically significant（P〈0.05）. The observation group had obviously better activities of daily living（ADL） classification than the control group, and the difference was statistically significant（U=2.008, P〈0.05）. The observation group had obviously lower death rate（2.70%） than the control group（16.22%）, and the difference was statistically significant（P〈0.05）. Conclusion Application of microsurgery via lateral fissure approach provides less postoperative complications for the treatment of patients with basal ganglia hypertensive cerebral hemorrhage. It is more consistent with the concept of minimally invasive, and can significantly reduce the patient＇s brain cell damage with accurate effect. It is worthy of clinical promotion.

关 键 词：高血压脑出血 基底节区 侧裂入路 显微手术 

分 类 号：R651.12[医药卫生—外科学]