小骨窗经外侧裂手术治疗基底节区高血压脑出血的疗效  

The Curative Effect of Small Bone Window through Lateral Fissure Surgery in the Treatment of Hypertensive Cerebral Hemorrhage in the Basal Ganglia

作　　者：刘军[1] 陈泽军[1] 庄严[1] 邓引生[1] 蒋明[1] LIU Jun;CHEN Zejun;ZHUANG Yan;DENG Yinsheng;JIANG Ming(Department of Neurosurgery,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu Province,212000 China)

机构地区：[1]江苏大学附属医院神经外科,江苏镇江212000

出　　处：《中外医疗》2021年第36期5-8,共4页China & Foreign Medical Treatment

基　　金：镇江市2017年度科技创新资金-社会发展项目(SH2017017)。

摘　　要：目的评价基底节区高血压脑出血患者应用小骨窗经外侧裂手术治疗的效果。方法方便选取2018年1月—2021年6月在江苏大学附属医院神经外科接受手术治疗的106例基底节区高血压脑出血患者,根据不同手术方案分为对照组(传统开颅手术治疗,n=53)与观察组(小骨窗经外侧裂手术治疗,n=53)。将两组小骨窗经外侧裂手术患者的术后住院时间、拔管时间、手术时间、术中出血量、术后并发症发生率及神经功能康复情况予以比较。结果观察组术后住院时间(26.38±7.06)d、拔管时间(1.55±1.15)d和手术时间(81.38±15.91)min均短于对照组(41.75±8.70)d、(2.23±1.98)d、(90.00±18.66)min;观察组术中出血量(176.42±119.49)mL小于对照组术中出血量(232.46±152.95)mL,差异有统计学意义(t=2.088、2.162、2.269、2.101,P=0.039、0.032、0.011、0.038)。观察组术后3个月的并发症肺部感染、颅内感染、消化道出血发生率均低于对照组,差异有统计学意义(χ^(2)=4.711、1.372、2.447,P=0.029、0.241、0.117);观察组术后GCS评分(12.64±3.41)分高于对照组(11.15±3.56)分,术后NIHSS评分(11.36±7.26)分低于对照组(16.81±7.84)分,术后MBI评分(51.62±26.30)分高于对照组MBI评分(33.51±27.20)分,差异有统计学意义(t=2.200、3.713、3.484,P<0.05)。结论基底节区高血压脑出血患者应用小骨窗经外侧裂手术治疗的效果显著,可以降低患者术后并发症发生率,改善患者的康复效果。Objective To evaluate the effect of treatment of patients with hypertensive intracerebral hemorrhage in the basal ganglia area using small bone window transsylvian fissure surgery.Methods A total of 106 patients with hypertensive cerebral hemorrhage in the basal ganglia area who underwent surgical treatment in the Department of Neurosurgery of the Affiliated Hospital of Jiangsu University from January 2018 to June 2021 were conveniently selected.Divided into the control group(traditional craniotomy treatment,n=53)and the observation group(small bone window translateral fissure surgery,n=53)according to different surgical plans.The postoperative hospital stay,extubation time,operation time,intraoperative blood loss,postoperative complication rate,and neurological rehabilitation of the two groups of patients with small bone window transsylvian fissure surgery were compared.Results The postoperative hospital stay(26.38±7.06)d,extubation time(1.55±1.15)d and operation time(81.38±15.91)min in the observation group were shorter than those in the control group(41.75±8.70)d,(2.23±1.98)d,(90.00±18.66)min.the intraoperative blood loss in the observation group(176.42±119.49)mL was less than that in the control group(232.46±152.95)mL,and the difference was statistically significant(t=2.088,2.162,2.269,2.101,P=0.039,0.032,0.011,0.038).The incidence of pulmonary infection,intracranial infection and gastrointestinal bleeding in the observation group was lower than that in the control group 3 months after operation,and the difference was statistically significant(χ^(2)=4.711,1.372,2.447,P=0.029,0.241,0.117).The postoperative GCS score of the observation group(12.64±3.41)points was higher than that of the control group(11.15±3.56)points,and the postoperative NIHSS score of the observation group(11.36±7.26)points was lower than that of the control group(16.81±7.84)points,the postoperative MBI score(51.62±26.30)points was higher than that of the control group(33.51±27.20)points,and the difference was statistically si

关 键 词：小骨窗经外侧裂手术 基底节区高血压脑出血 效果 

分 类 号：R651[医药卫生—外科学]