经侧裂岛叶入路与经颞岛叶入路治疗高血压脑出血的临床效果  

Clinical effects of transsylvian transinsular approach and transtemporal insular approach in the treatment of hypertensive cerebral hemorrhage

作　　者：李峰 高珂[2] LI Feng;GAO Ke(Tongchuan Mining Bureau Central Hospital,Tongchuan 727000;the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]铜川矿务局中心医院,陕西铜川727000 [2]西安交通大学第一附属医院,陕西西安710061

出　　处：《临床医学研究与实践》2023年第30期17-20,共4页Clinical Research and Practice

基　　金：国家自然科学基金资助项目(No.81602210)。

摘　　要：目的分析经侧裂岛叶入路与经颞岛叶入路治疗高血压脑出血的临床效果。方法选取2017年10月至2020年6月接受手术治疗的136例高血压脑出血患者,以随机数字表法将其分为对照组和研究组,每组68例。对照组给予经颞岛叶入路手术治疗,研究组给予经侧裂岛叶入路手术治疗。比较两组的治疗效果。结果研究组的手术时间显著长于对照组,术中血肿清除率显著高于对照组,术后7 d脑水肿体积小于对照组,住院时间短于对照组(P<0.05)。术后7、14 d,研究组的格拉斯哥昏迷评分法(GCS)高于对照组(P<0.05)。术后3、6个月,研究组的日常生活能力量表(ADL)评分高于对照组(P<0.05)。术后7、14 d,研究组的S100B蛋白和神经元特异性烯醇化酶(NSE)水平低于对照组(P<0.05)。研究组的并发症总发生率显著低于对照组(P<0.05)。结论经侧裂岛叶入路手术方式可有效缩短高血压脑出血患者的住院时间,有助于恢复日常生活能力、提升GCS评分及血肿清除率,同时还具有减小术后脑水肿体积,减少神经元损伤、降低术后并发症发生率等优势。Objective To analyze the clinical effects of transsylvian transinsular approach and transtemporal insular approach in the treatment of hypertensive cerebral hemorrhage.Methods A total of 136 patients with hypertensive cerebral hemorrhage who underwent surgical treatment from October 2017 to June 2020 were selected and divided into control group and study group by random number table method,with 68 cases in each group.The control group was given surgical treatment through the transtemporal insular approach,and the study group was given surgical treatment through the transsylvian transinsular approach.The therapeutic effects of the two groups were compared.Results The operation time of the study group was significantly longer than that of the control group,the intraoperative hematoma clearance rate was significantly higher than that of the control group,the cerebral edema volume at 7 d after operation was smaller than that of the control group,and the hospitalization time was shorter than that of the control group(P<0.05).At 7 and 14 d after operation,the Glasgow Coma Scale(GCS)score of the study group was higher than that of the control group(P<0.05).At 3 and 6 months after operation,the Activity of Daily Living Scale(ADL)score of the study group was higher than that of the control group(P<0.05).At 7 and 14 d after operation,the levels of S100B protein and neuron specific enolase(NSE)in the study group were lower than those in the control group(P<0.05).The total incidence of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion The operation method of transsylvian transinsular approach can effectively shorten the hospitalization time of patients with hypertensive cerebral hemorrhage,help to restore daily living ability,and improve GCS score and hematoma clearance rate.At the same time,it also has the advantages of reducing the volume of postoperative cerebral edema,neuronal damage and the incidence of postoperative complications.

关 键 词：经侧裂岛叶入路 经颞岛叶入路 高血压脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]