经侧裂-岛叶入路显微手术与常规大骨瓣开颅血肿清除术治疗高血压性基底核区脑出血效果对比观察  

Comparative observation of effects of lateral fissure-insula lobe approach microsurgery and conventional craniotomy accompanied by cranioplasty in the treatment of hypertensive basal ganglia intracerebral hemorrhage

作　　者：任振强[1] 关毅[1] 史永涛[1] 彭飞 REN Zhen-qiang;GUAN Yi;SHI Yong-tao;PENG Fei(Department of Neurosurgery , Second Affiliated Hospital of Luohe Medical College, Luohe, Henan 462000, China)

机构地区：[1]漯河医学高等专科学校第二附属医院神经外科,河南漯河462000

出　　处：《青岛医药卫生》2019年第2期90-93,共4页Qingdao Medical Journal

摘　　要：目的对比经侧裂-岛叶入路显微手术与常规大骨瓣开颅血肿清除术治疗基底核区高血压性脑出血(Hypertensive intracerebral hemorrhage,HICH)的效果。方法选取2015年2月至2018年2月本院收治的84例高血压性基底核区脑出血患者进行研究,按随机数字法分为观察组和对照组各42例,观察组行经侧裂-岛叶入路显微手术治疗,对照组实施常规大骨瓣开颅血肿清除术治疗,比较两组围术期情况(包括手术时间、术中出血量、血肿清除率)、手术并发症(包括再出血、颅内感染、肺部感染、脑脊液漏液、皮下积液)发生率及术前、术后1、3、6个月日常生活能力量表(ADL)评分。结果观察组手术时间、术中出血量及术后意识恢复时间少于对照组,血肿清除率高于对照组(P<0.05);观察组再出血、颅内感染、肺部感染、脑脊液漏液、皮下积液等并发症发生率(11.90%)低于对照组(40.48%)(P<0.05);观察组患者术后1、3、6个月ADL评分均高于对照组(P<0.05)。结论与常规大骨瓣开颅血肿清除术相比,经侧裂-岛叶入路显微手术治疗高血压性基底核区脑出血效果较好,可减少并发症的发生,患者术后康复良好。Objective To compare the effects of lateral fissure-insula lobe approach microsurgery and conventional craniotomy accompanied by cranioplasty in the treatment of hypertensive intrac-erebral hemorrhage (HICH) in basal ganglia. Methods A total of 84 cases of patients with hy-pertensive basal ganglia intracerebral hemorrhage in our hospital from February 2015 to February 2018 were selected for the study and were divided into observation group and control group ac-cording to the random number table method, with 42 cases in each group. Observation group was given lateral fissure-insula lobe approach microsurgery, and control group was treated with con-ventional craniotomy accompanied by cranioplasty. The perioperative conditions (including opera-tive time, intraoperative blood loss, hematoma clearance rate), incidence rate of surgical compli-cations (including re-bleeding, intracranial infection, pulmonary infection, cerebrospinal fluid leakage, subcutaneous effusion) and ability of daily living scale (ADL) score before operation and at 1 month, 3 months and 6 months after operation were compared between the two groups. Re-sults The operative time, intraoperative blood loss and postoperative recovery time of conscious-ness in observation group were less than those in control group? and the hematoma clearance rate was higher than that in control group (P<0.05). The incidences of complications of re-bleeding, intracranial infection, pulmonary infection, cerebrospinal fluid leakage and subcutaneous effusion in observation group were lower than those in control group (11? 90% vs 40? 48%)(P<0.05). The ADL scores in observation group at 1 month, 3 months and 6 months after operation were higher than those in control group (P<0.05). Conclusion Compared with conventional craniot-omy accompanied by cranioplasty, lateral fissure-insula lobe approach microsurgery has good effects in treating hypertensive basal ganglia intracerebral hemorrhage, and it can reduce the oc-currence of complications and has good postoperative rehabili

关 键 词：基底核区脑出血 高血压 侧裂-岛叶入路 大骨瓣开颅血肿清除术 

分 类 号：R651.1[医药卫生—外科学]