经外侧裂-岛叶入路手术治疗高血压性基底节区出血的疗效分析  

Analysis of curative effects of surgery through transsylvian-insular approach on hypertensive basal ganglia hemorrhage

作　　者：孙青[1] 刘永春 尤万春[1] 高薇[1] 陆挺[1] 李金泉[1] 陈罡[1] 王中[1] SUN Qing;LIU Yong-chun;YOU Wan-chun;GAO Wei;LU Ting;Li Jin-quan;CHEN Gang;WANG Zhong(Department of Neurosurgery, The First Affiliated Hospital, Soochow University, Suzhou 215006, China)

机构地区：[1]苏州大学附属第一医院神经外科,江苏苏州215006

出　　处：《中国临床神经外科杂志》2019年第1期16-18,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家重点研发计划(2018YFC1312600;2018YFC1312601);江苏省青年医学重点人才计划(QNRC2016727)

摘　　要：目的探讨经外侧裂-岛叶入路显微手术治疗高血压性基底节区出血的疗效。方法回顾分析手术治疗的59例高血压性基底节区出血的临床资料。根据手术方式,分为对照组(经颞叶皮层入路40例)以及观察组(经外侧裂-岛叶入路19例)。结果观察组术中责任动脉发现率(42.1%,8/19)明显高于对照组(10%,4/40;P<0.05),术后再出血率(0%)明显低于对照组(20.0%,8/40;P<0.05)。术后半年,观察组GOS评分[(3.7±1.4)分]明显高于对照组[(2.6±1.4)分;P<0.05],偏瘫侧肌力好转率(82.4%,14/17)明显高于对照组(51.9%,14/27;P<0.05);但两组病死率、失语好转率均无统计学差异(P>0.05)。结论经外侧裂-岛叶入路手术治疗高血压性基底节区出血技术容易掌握,实用性强,术后病情稳定,有利于改善病人预后。Objective To investigate the curative effects of surgery through transsylvian-insular approach on hypertensive basal ganglia hemorrhage (HBGH). Methods The clinical data of 59 patients with HBGH, of whom, 40 underwent the surgery through transtemporal cortex approach (control group) and 19 through transsylvian- insular approach (observed group), were analyzed retrospectively. The outcomes of surgery were compared between both the groups. Results The rate of finding the artery responsible for bleeding was significantly higher in the observed group (42.1%, 8/19) than that (10%, 4/40) in the control group (P<0.05). The postoperative rebleeding rate (0.0%) was significantly lower in the observed group than that (20.0%, 8/40) in the control group (P<0.05). GOS scores [(3.7±1.4) points] half a year after the surgery was significantly higher in the observed group than that [(2.6±1.4) points] in the control group (P<0.05). The improvement rate of hemiplegia (82.4%, 14/17) was also significantly higher in the observed group than that (51.9%, 14/17) in the control group (P<0.05). Conclusion The tanssylvivan-insular approach microsurgery is helpful to reducing the rebleeding rate and improvement of the prognosis in the patients with basal ganglia hemorrhage.

关 键 词：高血压性脑出血 基底节 手术入路 显微手术 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]