显微镜下经侧裂入路高血压基底节区脑出血清除术的疗效分析  

Therapeutic Effectiveness in the Microsurgical Removal of Hypertensive Basal Ganglia Hematoma by Lateral Fissure Approach

作　　者：徐剑峰[1] 吴贵强[1] 曾令勇[1] 张海[1] 高阳[1] 邓李[1] 任林强[1] 张波[1] 刘藻滨 刘阳[1] 曹辉[1] Xu Jianfeng;Wu Guiqiang;Zeng Lingyong;Zhang Hai;Gao Yang;Deng Li;Ren Linqiang;Zhang Bo;Liu Zaobin;Liu Yang;Cao Hui(Department of Neurosurgery, The Third Hospital of Mianyang & Sichuan Mental Health Center, Mianyang 621000, China)

机构地区：[1]绵阳市第三人民医院·四川省精神卫生中心神经外科

出　　处：《成都医学院学报》2019年第4期435-439,共5页Journal of Chengdu Medical College

基　　金：四川省科技厅科技支撑项目(No:2015SZ0051);四川省医学会项目(No:S16038);绵阳市卫生和计划生育委员会科研课题项目(No:201724)

摘　　要：目的探讨显微镜下经侧裂入路高血压基底节区脑出血清除术的疗效。方法选取2017年1月至2018年1月,绵阳市第三人民医院神经外科收治的经手术治疗的高血压基底节区脑出血患者181例为研究对象,根据手术方式的不同,将采用经侧裂入路高血压基底节区脑出血清除术的患者设为试验组(n=79),将采用经皮层入路高血压基底节区脑内血肿清除术的患者设为对照组(n=102)。比较两组患者术后1个月格拉斯哥昏迷评分(GCS)、术后1个月患侧肢体肌力分级级别、术后6个月日常生活能力分级(ADL)评分,并评价临床疗效。结果试验组患者术后1个月GCS评分、术后1个月患侧肢体肌力分级及术后6个月ADL评级方面均优于对照组患者,差异均有统计学意义(P<0.05)。结论显微镜下经侧裂入路高血压基底节区脑出血清除术整体手术效果好,对患者正常组织的创伤及影响小,预后改善明显,值得在有条件开展的医院推广并加以改进。Objective To evaluate the therapeutic effectiveness in the microsurgical removal of hypertensive basal ganglia hematoma by lateral fissure approach. Methods A total of 181 patients with hypertensive basal ganglia hemorrhage treated in The Third Hospital of Mianyang from January of 2017 to January of 2018 were selected as the subject and divided into the observation group given the hypertensive basal ganglia hematoma evacuation by lateral fissure approach and the control group treated with the hypertensive basal ganglia hematoma evacuation by transcortical approach according to the different surgical methods. The two groups were compared in Glasgow Coma Score (GCS) and lateral limb muscle grading one month after surgery and the postoperative classification of Activities of Daily Living (ADL) six months after surgery to evaluate the therapeutic effectiveness. Results The observation group was significantly better than the control group in the GCS score and lateral limb muscle grading one month after surgery and the postoperative ADL classification six months after surgery ( P <0.05). Conclusion The microsurgical removal of hypertensive basal ganglia hematoma by lateral fissure approach is effective in the treatment of hypertensive basal ganglia hemorrhage with little trauma and influence on patients' normal tissues and significant improvement in prognosis, therefore, it is worth promoting and improving in hospitals with appropriate conditions.

关 键 词：基底节区脑出血 显微神经外科 侧裂入路 日常生活能力分级 格拉斯哥昏迷评分 

分 类 号：R651.12[医药卫生—外科学]