锁孔入路显微镜下经外侧裂-岛叶与颞叶沟裂造瘘治疗基底核区血肿的临床分析  

Clinical analysis of treatment of hematoma in the basal ganglia by sylvian fissure-insular lobe and temporal sulcus fissure under the keyhole microscope

作　　者：刘海兵 洪景芳 赵琳 薛亮 张尚明 魏梁锋 王守森 Liu Haibing;Hong Jingfang;Zhao Lin;Xue Liang;Zhang Shangming;Wei Liangfeng;Wang Shousen(Department of Neurosurgery,900 Hospital of PLA,Fuzhou,Fujian 350025,China)

机构地区：[1]解放军第九〇〇医院神经外科

出　　处：《中国微侵袭神经外科杂志》2019年第11期490-493,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：军队后勤科研计划重点项目子课题(编号：AHJ14J001-2);福建省自然科学基金(编号：2016J01587);福建医科大学起航基金一般项目(编号：2018QHl236)

摘　　要：目的比较锁孔入路经外侧裂-岛叶和颞叶沟裂造瘘治疗基底核区血肿的疗效。方法回顾性分析109例基底核区脑出血病例资料。外侧裂组47例,采用锁孔入路经外侧裂-岛叶进入血肿腔;颞叶沟裂组62例,采用锁孔入路经颞叶沟裂造瘘进入血肿腔。结果两组手术时间、血肿清除量、术后并发症及术后3个月GOS比较,差异均无统计学意义(均P>0.05);外侧裂组术中出血量与术中止血时间明显少于颞叶沟裂组,差异具有统计学意义(均P<0.001)。结论锁孔入路能很好完成血肿清除,外侧裂-岛叶入路手术治疗基底核区脑出血优于颞叶沟裂入路。Objective To compare the effects of the keyhole approach through sylvian fissure-insular lobe and temporal sulcus fissure for the treatment of cerebral hematoma in the basal ganglia.Methods Clinical data of 109 patients with cerebral hemorrhage in the basal ganglia were analyzed retrospectively.In the sylvian fissure group,47 patients were treated with a keyhole approach through the sylvian fissure-insular lobe into the hematoma cavity.In the temporal sulcus fissure group,62 patients were treated with a keyhole approach through the temporal lobe sulcus into the hematoma cavity.Results There were no significant differences between the two groups in time of operation,removed volume of hematoma,postoperative complications and the Glasgow Outcome Score 3 month after the operation(all P>0.05).The amount of hemorrhage and intraoperative hemostasis in the sylvian fissure group was significantly less than that in the temporal sulcus fissure group,and the difference was statistically significant(both P<0.001).Conclusions The keyhole approach can complete the removal of hematoma,and the sylvian fissure-insular lobe approach for cerebral hemorrhage in the basal ganglia is superior to the temporal sulcus fissure approach.

关 键 词：颅内出血 高血压性 基底核区 锁孔 外侧裂-岛叶入路 脑沟回裂入路 

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