显微镜下经侧裂-岛叶入路血肿清除术治疗高血压基底节区脑出血的效果分析  

Effect analysis of hematomas removal by lateral fissure-insula approach in treatment of hypertensive basal ganglia cerebral hemorrhage under microscope

作　　者：薛铁栓 李丽 陈胜 Xue Ties-huan;Li Li;Chen Sheng(Department of Neurosurgery,Neixiang People's Hospital,Nanyang 474350,Henan,China)

机构地区：[1]内乡县人民医院神经外科,河南南阳474350

出　　处：《四川生理科学杂志》2025年第3期553-555,562,共4页

摘　　要：目的:观察显微镜下经侧裂-岛叶入路血肿清除术治疗高血压基底节区脑出血的临床效果。方法:回顾性收集本院2020年6月-2023年6月期间收治的83例高血压基底节区脑出血患者的临床资料。全部患者均行血肿清除术。按照患者接受的不同入路手术将其分为对照组(n=40例,经颞叶皮质入路)和研究组(n=43例,显微镜下经侧裂-岛叶入路)。分析对比两组的手术情况[手术时间、术后24h格拉斯哥昏迷评分(GCS)]、术后48h血肿清除情况以及日常生活活动能力[经Barthel指数评估]。结果:研究组的手术时间较对照组显著缩短,研究组术后24hGCS评分显著高于对照组(P<0.05)。研究组术后48h血肿总清除率较对照组显著提高(P<0.05)。术后6个月,两组d额Barthel指数均较术后7d有不同程度升高,且研究组的Barthel指数显著高于对照组(P<0.05)。结论:显微镜下经侧裂-岛叶入路血肿清除术治疗高血压基底节区脑出血,较经颞叶皮质入路能缩短手术时间、降低术后24hGCS评分,提升患者术后48h血肿清除率,促进术后日常生活活动能力的恢复。Objective:To observe the clinical effect of lateral fissure-insula approach hematomas removal in the treatment of hypertensive basal ganglia cerebral hemorrhage under microscope.Methods:The clinical data of 83 patients with hypertensive basal ganglia cerebral hemorrhage admitted to our hospital from June 2020 to June 2023 were retrospectively collected.All patients underwent hematoma removal.Patients were divided into control group(n=40 cases,transtemporal cortex approach)and study group(n=43 cases,microscopically translateral fissure-insula approach)according to the different approaches they had received.The operation conditions[operation time,Glasgow Coma Score(GCS)24 hours after surgery],hematoma clearance 48 hours after surgery,and activities of daily living(as assessed by Barthel index)of the two groups were analyzed and compared.Results:The operation time of the study group was significantly shorter than that of the control group,and the 24hGCS score of the study group was significantly higher than that of the control group(P<0.05).The total hematoma clearance rate of the study group was significantly higher than that of the control group 48 hours after operation(P<0.05).At 6 months after surgery,the D-forehead Barthel index in both groups was higher than that on 7 days after surgery,and the Barthel index in the study group was significantly higher than that in the control group(P<0.05).Conclusion:Compared with the temporal cortex approach,the lateral fusion-insula approach can shorten the operation time,reduce the postoperative 24hGCS score,improve the postoperative 48h hematoma clearance rate,and promote the recovery of postoperative activities of daily living.

关 键 词：高血压 脑出血 血肿清除术 经侧裂-岛叶入路 经颞叶皮质入路 

分 类 号：R74[医药卫生—神经病学与精神病学]