小骨窗经侧裂下Rolandic点-岛叶入路手术治疗高血压性基底节区后部脑出血的效果及预后分析  

Effect and prognosis analysis of hypertensive posterior basal ganglia intracerebral hemorrhage treated by the small bone window through the lateral fissure Rolandic point-insular lobe approach

作　　者：钱洪波[1] 殷骏[1] 潘捷[1] QIAN Hongbo;YIN Jun;PAN Jie(Department of Neurosurgery,the First People’s Hospital of Anqing,Anhui Province,Anqing246004,China)

机构地区：[1]安徽省安庆市第一人民医院神经外科,安徽安庆246004

出　　处：《中国医药导报》2021年第2期65-68,共4页China Medical Herald

摘　　要：目的探讨小骨窗经侧裂下Rolandic点-岛叶入路手术治疗高血压性基底节区后部脑出血的疗效及预后。方法选择安徽省安庆市第一人民医院神经外科2016年1月-2019年10月接诊的高血压性基底节区后部脑出血患者90例,按照随机数字表法将其分为观察组和对照组,每组各45例。观察组使用小骨窗经侧裂下Rolandic点-岛叶入路进行血肿清除术,对照组采用传统的小骨窗经颞叶皮质入路进行血肿清除术。比较两组围术期情况、格拉斯哥昏迷评分(GCS)、格拉斯哥预后评分(GOS)的变化,并记录两组术后并发症。结果观察组术后自动睁眼时间短于对照组,术后24 h血肿清除率高于对照组,差异均有统计学意义(均P<0.05)。两组术后1周GCS均较术前增加,且观察组高于对照组,差异均有统计学意义(均P<0.05);随访显示,观察组预后良好率高于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论小骨窗经侧裂下Rolandic点-岛叶入路手术治疗高血压性基底节区后部脑出血的效果显著,具有血肿清除率高、术后恢复快、并发症少等特点,预后良好,值得应用推广。Objective To study the effect and prognosis of hypertensive posterior basal ganglia intracerebral hemorrhage treated by the small bone window through the lateral fissure Rolandic point-insular lobe approach.Methods A total of 90 patients with hypertensive posterior basal ganglia intracerebral hemorrhage admitted to the Department of Neurosurgery,the First People’s Hospital of Anqing,Anhui Province from January 2016 to October 2019 were selected and divided into observation group and control group according to the random number table method,with 45 patients in each group.The observation group was hematoma removal by the small bone window through the lateral fissure Rolandic point-insular lobe approach,while the control group was hematoma removal by the traditional small bone window through the temporal cortical approach.The perioperative situation,the changes of the Glasgow coma score(GCS),Glasgow prognosis score(GOS)were compared between the two groups,and the postoperative complications were recorded.Results In the observation group,the postoperative automatic eye opening time was shorter than that in the control group,and the hematoma removal rate 24 h after the surgery was higher than that in the control group,with statistically significant differences(all P<0.05).The GCS at one week after surgery in both groups were increased compared with that before surgery,and the observation group was higher than that in the control group,with statistically significant differences(all P<0.05).Follow-up showed that the rate of good prognosis in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The small bone window through the lateral fissure Rolandic point-insular lobe approach is well for hypertensive posterior basal ganglia intracerebral hemorrhage,which have the characteristics o

关 键 词：高血压脑出血 基底节区后部 侧裂下Rolandic点-岛叶入路 颞叶皮质入路 预后 疗效 

分 类 号：R544.1[医药卫生—心血管疾病]