神经内镜辅助经侧裂-岛叶入路血肿清除术在基底节区脑出血患者中的应用效果  

Application Effect of Neuroendoscopy-Assisted Hematoma Evacuation Surgery Approach Through the Lateral Fissure and Insula in Patients with Cerebral Hemorrhage in Basal Ganglia Region

作　　者：苗红星 MIAO Hongxing(Department of Neurosurgery,Zouping People's Hospital,Binzhou 256200,China)

机构地区：[1]邹平市人民医院神经外科,山东滨州256200

出　　处：《反射疗法与康复医学》2024年第13期142-145,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨神经内镜辅助经侧裂-岛叶入路血肿清除术在基底节区脑出血患者中的应用效果。方法选取2019年6月—2023年8月邹平市人民医院收治的50例基底节区脑出血患者为研究对象,按随机数字表法将其分为对照组和观察组,每组25例。对照组采用经颞叶皮层入路血肿清除术治疗,观察组采用神经内镜辅助经侧裂岛叶入路血肿清除术治疗。比较两组患者围术期指标、血清神经损伤因子水平、炎性因子水平、手术并发症发生情况。结果观察组手术时间、术后意识恢复时间、住院时间分别为(2.14±0.56)h、(5.04±0.67)h、(11.25±1.31)d,均短于对照组的(2.76±0.69)h、(6.59±0.73)h、(13.72±2.15)d,组间差异有统计学意义(P<0.05)。术后3 d,胶质纤维酸性蛋白、星形胶质源性蛋白、神经元特异性烯醇化酶、白细胞介素-4、C反应蛋白及肿瘤坏死因子-α水平均低于对照组,组间差异有统计学意义(P<0.05)。术中出血量、手术并发症发生率比较,组间差异无统计学意义(P>0.05)。结论神经内镜辅助经侧裂-岛叶入路血肿清除术在基底节区脑出血患者治疗中获得效果较好,手术对患者造成创伤较小,手术时间及术后恢复时间均较短,有助于减轻对脑部神经功能损伤,同时术后炎性因子水平较低,安全可靠,值得推广应用。Objective To explore the application effect of neuroendoscopy-assisted hematoma evacuation surgery approach through the lateral fissure and insula in patients with cerebral hemorrhage in basal ganglia region.Methods A total of 50 patients with basal ganglia region cerebral hemorrhage treated in Zouping People's Hospital from June 2019 to August 2023 were selected as the research objects,and were divided into a control group and an observation group according to random number table method,with 25 cases in each group.The control group was treated with hematoma removal via temporal cortex approach,and the observation group was treated with the neuroendoscopy-assisted removal of hematoma through the lateral fissure and insula approach.Perioperative indicators,serum levels of nerve injury factors,inflammatory factors and occurrence of surgical complications were compared between the two groups.Results The operation time,postoperative consciousness recovery time and hospitalization time in the observation group were(2.14±0.56)h,(5.04±0.67)h and(11.25±1.31)d,which were shorter than(2.76±0.69)h,(6.59±0.73)h and(13.72±2.15)d in the control group,and the differences between the groups were statistically significant(P<0.05).After 3 days of operation,the levels of glial fibroacidic protein,astroglial derived protein,neuron-specific enolase,interleukin-4,C-reactive protein and tumor necrosis factor-α were lower than those of the control group,and the differences between the groups were statistically significant(P<0.05).Comparison of intraoperative blood loss and incidence of surgical complications,and the differences were no statistically significant(P>0.05).Conclusion Neuroendoscopy-assisted hematoma evacuation surgery via the lateral fass-insula approach has yielded favorable results in the treatment of patients with basal ganglia region cerebral hemorrhage.The surgery has less trauma to the patients,the operation time and postoperative recovery time are short,which is helpful to reduce the damage to the brain nerve

关 键 词：基底节区脑出血 神经内镜 经侧裂-岛叶入路 血肿清除术 神经损伤因子 炎性因子 

分 类 号：R743.34[医药卫生—神经病学与精神病学]