显微镜下经侧裂入路开颅血肿清除术治疗基底节区高血压脑出血的临床效果  

Clinical Effect of Craniotomy Hematoma Removal Through Lateral Fissure Approach under Microscope in the Treatment of Hypertensive Intracerebral Hemorrhage in Basal Ganglia Region

作　　者：官志豪 赵丽丽 黄立刚 GUAN Zhihao;ZHAO Lili;HUANG Ligang(Department of Neurosurgery,Fangzi District People's Hospital,Weifang 261200,Shandong,China;Department of Neurology,Fangzi District People's Hospital,Weifang 261200,Shandong,China)

机构地区：[1]潍坊市坊子区人民医院神经外科,山东潍坊261200 [2]潍坊市坊子区人民医院神经内科,山东潍坊261200

出　　处：《世界复合医学（中英文）》2024年第8期115-118,共4页World Journal of Complex Medicine

摘　　要：目的分析基底节区高血压脑出血(hypertensive intracerebral hemorrhage,HICH)患者实施显微镜下经侧裂入路开颅血肿清除术的价值。方法选取2022年1月—2024年1月潍坊市坊子区人民医院收治的56例基底节区HICH患者作为研究对象,根据不同手术路径分为对照组、研究组,各28例。两组均行开颅血肿清除术,对照组经颞叶皮层位置入路,研究组在显微镜下经侧裂入路。比较两组血肿清除效果、转归情况、生存质量及并发症总发生率。结果研究组血肿清除率高于对照组,住院时间短于对照组,差异有统计学意义(P均<0.05)。两组术中出血量、手术耗时比较,差异无统计学意义(P均>0.05)。术前两组格拉斯哥结果评分比较,差异无统计学意义(P>0.05)。术后3 d、10 d,研究组格拉斯哥结果评分高于对照组,差异有统计学意义(P<0.05)。术后,研究组生活质量评分高于对照组,差异有统计学意义(P均<0.05)。研究组并发症总发生率为3.57%(1/28),低于对照组的21.43%(6/28),差异有统计学意义(χ^(2)=4.082,P=0.043)。结论经侧裂入路显微镜下开颅血肿清除术的血肿清除率高、康复时间短,术后转归好,患者生活质量较高,并发症较少。Objective To analyze the value of craniotomy hematoma evacuation through lateral fissure approach under microscope of patients with hypertensive intracerebral hemorrhage(HICH)in basal ganglia.Methods From January 2022 to January 2024,56 patients with HICH in the basal ganglia admitted to Fangzi District People's Hospital were selected as the research objects.They were divided into control group and study group according to different surgical paths,with 28 cases in each group.Both groups underwent craniotomy hematoma removal.The control group was treated with temporal lobe cortex position approach,and the study group was treated with lateral fissure approach under microscope.The hematoma clearance effect,outcome,quality of life and complication rate were compared between the two groups.Results The hematoma clearance rate of the study group was higher than that of the control group,and the hospitalzation time was shorter than that of the control group,and the differences were statistically significant(both P<0.05).There was no significant difference in intraoperative blood loss and operation time between the two groups(both P>0.05).There was no significant difference in Glasgow Outcome Scores between the two groups before operation(P>0.05).At 3 d and 10 d after operation,the Glasgow Outcome Scores of the study group were higher than that of the control group,and the difference was statistically significant(P<0.05).After operation,the quality of life score of the study group were higher than tthose of the control group,and the differences were statistically significant(all P<0.05).The incidence of complications in the study group was 3.57%(1/28),which was lower than 21.43%(6/28)in the control group,and the difference was statistically significant(χ^(2)=4.082,P=0.043).Conclusion Microscopic craniotomy hematoma removal through lateral fissure approach has high hematoma clearance rate,short recovery time,good postoperative outcome,high quality of life,and the complications were less.

关 键 词：开颅血肿清除术 生存质量 高血压脑出血 基底节区 经侧裂入路 

分 类 号：R651.1[医药卫生—外科学]