经外侧裂岛叶入路与经颞叶皮质入路在单侧高血压性壳核出血手术中的应用效果比较  

Comparison of efficacy of the lateral fissure insular approach and the temporal cortex approach in unilateral hypertensive putamen hemorrhage

作　　者：赵焕燕[1] 李军 勾海超 李继华[1] ZHAO Huan-yan;LI Jun;GOU Hai-chao(Department of Neurosurgery,Kailuan General Hospital,Tangshan Hebei 063021,China;Department of Neurosurgery,Shaanxi Friendship Hospital,Xi'an Shaanxi 710068,China)

机构地区：[1]开滦总医院神经外科,河北唐山063021 [2]陕西省友谊医院神经外科,陕西西安710068

出　　处：《临床和实验医学杂志》2020年第13期1399-1402,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的对比观察单侧高血压性壳核出血(HPH)手术中经外侧裂岛叶入路与经颞叶皮质入路的应用效果。方法采用回顾性研究方法,选取2018年1月至2020年1月开滦总医院神经外科收治的单侧高血压性壳核出血患者170例,根据手术方式不同将其分为两组:对照组和研究组,每组各85例。对照组患者采用经颞叶皮质入路手术治疗,研究组患者采用经外侧裂岛叶入路手术治疗。比较两组患者手术治疗后的意识状态及神经功能恢复良好率、血肿清除率、语言功能及预后情况。结果与对照组相比,研究组患者手术治疗后意识状态及神经功能恢复良好率(60.00%vs.42.35%)、血肿清除率(65.88%vs.44.71%)、预后良好率(87.06%vs.57.65%)更高,再出血率(8.24%vs.27.06%)、完全性失语率(1.18%vs.16.47%)更低,差异均具有统计学意义(P<0.05)。结论单侧高血压性壳核出血治疗中,经外侧裂岛叶入路手术的应用效果明显优于经颞叶皮质入路手术,可有效清除患者壳核血肿,降低再出血率和完全性失语率,改善患者预后。Objective To compare and observe the effect of translateral fissure island approach and transtemporal cortical approach in unilateral hypertensive putamen hemorrhage(HPH)surgery.Methods Retrospective research methods was performed,170 patients with unilateral hypertensive putamen hemorrhage admitted to the Department of Neurosurgery,Kailuan General Hospital from January 2018 to January 2020 were selected and divided into two groups according to different surgical methods:control group and study group,85 cases in each group.The patients in the control group were treated with transtemporal cortical approach,and the patients in the study group were treated with lateral fissure access.Comparing the consciousness,neurological function recovery rate,hematoma clearance rate,language function and prognosis of the two groups of patients after surgical treatment.Results Compared with the control group,the recovery rate of consciousness and neurological function(60.00%vs.42.35%),hematoma clearance rate(65.88%vs.44.71%),and good prognosis rate(87.06%vs.57.65)of patients in the study group after surgery were higher,the rebleeding rate(8.24%vs.27.06%)and the complete aphasia rate(1.18%vs.16.47%)were lower,and the differences were statistically significant(P<0.05).Conclusion In the treatment of unilateral hypertensive putamen hemorrhage,the application of the lateral fissure island approach is significantly better than the transtemporal cortical approach,which can effectively remove the patient’s putamen hematoma,reduce the rebleeding rate and complete aphasia,improve the prognosis of patients.

关 键 词：单侧高血压性壳核出血 经外侧裂岛叶入路 经颞叶皮质入路 对比研究 

分 类 号：R651.1[医药卫生—外科学]