显微镜下经外侧裂入路手术治疗重症高血压基底节出血的临床效果分析  

Analysis on clinical effect of microsurgery via lateral fissure approach in treatment of severe hypertensive basal ganglia hemorrhage

作　　者：高玉华 魏民 夏鹏飞 张远明 GAO Yu-hua;WEI Min;XIA Peng-fei(Department of Neurosurgery,Gaochun People's Hospital,Nanjing 211300,China)

机构地区：[1]南京市高淳人民医院神经外科,南京211300

出　　处：《临床神经外科杂志》2020年第4期462-465,共4页Journal of Clinical Neurosurgery

摘　　要：目的研究显微镜下经外侧裂入路手术治疗重症高血压基底节出血的临床效果。方法高淳人民医院神经外科2017年8月—2018年8月收治的82例重症高血压基底节出血患者,依据手术方式不同将患者随机分为观察组和对照组,每组各41例。对照组患者行经颞叶皮质入路手术治疗,观察组患者行显微镜下经外侧裂入路手术治疗。比较两组患者术后的格拉斯哥昏迷量表(Glasgow coma scale,GCS)、格拉斯哥预后量表(Glasgow outcome scale,GOS)、日常生活能力(activities of daily living,ADL)、生活质量评分及治疗效果和并发症发生率。结果观察组术后的GOS、ADL和生活质量评分均显著优于对照组,总有效率明显高于对照组,并发症的发生率明显低于对照组,差异均有统计学意义(P<0.05~0.001)。结论采用显微镜下经外侧裂入路手术治疗重症高血压基底节出血,能够有效减轻患者术后的昏迷程度,改善神经功能,降低并发症发生率,提升患者的生活质量,对提高临床效果具有突出的价值。Objective To investigate the clinical effect of microsurgery via lateral fissure approach in the treatment of severe hypertensive basal ganglia hemorrhage.Methods 82 patients with severe hypertensive basal ganglia hemorrhage admitted at Gaochun People's Hospital from August 2017 to August 2018 were selected and divided into observation group and control group according to different surgical methods,with 41 cases each.The control group was treated by the temporal cortex approach,and the observation group was treated by the lateral fissure approach under the microscope.Postoperative Glasgow Coma Scale(GCS),Glasgow Outcome Scale(GOS),Activities of Daily Living(ADL),quality of life score,treatment effect and incidence of complications were recorded and compared between the two groups.Results Postoperative GOS,ADL and quality of life scores of the observation group were significantly better than the control group.The total effective rate was significantly higher than the control group.The incidence of complications was lower than the control group.The differences were statistically significant(P<0.05-0.001).Conclusion Microsurgery through the lateral fissure approach can effectively reduce the coma deepness of patients with severe hypertensive basal ganglia hemorrhage,improve their neurological function,reduce the postoperative complications,and improve the quality of life,which has outstanding value for improving the overall clinical treatment effect.

关 键 词：经外侧裂入路手术 高血压基底节出血 临床效果 

分 类 号：R651.1[医药卫生—外科学]