经侧裂-岛叶入路显微手术治疗基底节区高血压脑出血的效果及对神经功能、血管活性因子的影响  

Effect of microsurgery via lateral fissure insular approach in the treatment of hypertensive cerebral hemorrhage in basal ganglia region and its impacts on neurological function and vasoactive factors

作　　者：李俊明 王乃冰 LI Junming;WANG Naibing(No.4 Surgery Department,the People's Hospital of Nanzheng District,Hanzhong 723100;Neurosurgery Department,Xi'an International Medical Center Hospital,Xi'an 710100,China)

机构地区：[1]南郑区人民医院外四科,陕西汉中723100 [2]西安国际医学中心医院神经外科,陕西西安710100

出　　处：《临床医学研究与实践》2024年第34期71-74,共4页Clinical Research and Practice

摘　　要：目的探讨经侧裂-岛叶入路显微手术治疗基底节区高血压脑出血的效果。方法选取2022年1月至2023年3月收治的90例基底节区高血压脑出血患者作为研究对象,按手术方式的差异将其分为对照组和观察组,各45例。对照组采取经颞叶皮层入路显微手术,观察组采取经侧裂-岛叶入路显微手术。比较两组的治疗效果。结果观察组的血肿清除率、术后1周格拉斯哥昏迷量表(GCS)评分高于对照组,术后自动睁眼时间短于对照组,术后1周脑水肿体积小于对照组(P<0.05)。术后1周,观察组的神经元特异性烯醇化酶(NSE)、中枢神经特异性蛋白β(S-100β)、胶质纤维酸性蛋白(GFAP)水平均低于对照组(P<0.05)。术后1周,观察组的内皮素(ET)、血管升压素(AVP)水平低于对照组(P<0.05)。观察组的术后并发症总发生率低于对照组(P<0.05)。结论经侧裂-岛叶入路显微手术治疗基底节区高血压脑出血的效果显著,可改善患者神经功能、血管活性因子水平,降低术后并发症发生率,值得应用及推广。Objective To explore the effect of microsurgery via lateral fissure insular approach in the treatment of hypertensive cerebral hemorrhage in basal ganglia region.Methods A total of 90 patients with hypertensive cerebral hemorrhage in basal ganglia region admitted from January 2022 to March 2023 were selected as the research objects,and the patients were divided into control group and observation group according to the difference of surgical methods,with 45 cases in each group.The control group was treated with microsurgery via temporal lobe cortex approach,and the observation group was treated with microsurgery via lateral fissure insular approach.The therapeutic effects of the two groups were compared.Results The hematoma clearance rate and Glasgow Coma Scale(GCS)score at 1 week after operation in the observation group were higher than those in the control group,the automatic eye opening time after operation was shorter than that in the control group,and the volume of cerebral edema at 1 week after operation was smaller than that in the control group(P<0.05).At 1 week after operation,the levels of neuron-specific enolase(NSE),central nervous system specific proteinβ(S-100β)and glial fibrillary acidic protein(GFAP)in the observation group were lower than those in the control group(P<0.05).At 1 week after operation,the levels of endothelin(ET)and arginine vasopressin(AVP)in the observation group were lower than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion The microsurgery via lateral fissure insular approach in the treatment of hypertensive cerebral hemorrhage in basal ganglia region has a significant effect,it can improve the neurological function and vasoactive factors levels of patients and reduce the incidence of postoperative complications,which is worthy of application and promotion.

关 键 词：侧裂-岛叶入路 显微手术 基底节区 高血压脑出血 神经功能 血管活性因子 

分 类 号：R651.12[医药卫生—外科学]