[1]钟波,邹国荣,张冬根,等.经侧裂-岛叶入路与经皮层入路手术治疗高血压性基底节区出血的疗效[J].中国临床神经外科杂志,2024,29(05):264-267.[doi:10.13798/j.issn.1009-153X.2024.05.003]
　ZHONG Bo,ZOU Guo-rong,ZHANG Dong-gen,et al.Efficacy of microsurgery through transsylvian-insular and transcortical approaches for patients with hypertensive basal ganglia hemorrhage[J].,2024,29(05):264-267.[doi:10.13798/j.issn.1009-153X.2024.05.003]
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经侧裂-岛叶入路与经皮层入路手术治疗高血压性基底节区出血的疗效()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年05期
页码:
264-267
栏目:
论著
出版日期:
2024-05-30

文章信息/Info

Title:
Efficacy of microsurgery through transsylvian-insular and transcortical approaches for patients with hypertensive basal ganglia hemorrhage
文章编号:
1009-153X（2024）05-0264-04
作者:
钟波; 邹国荣; 张冬根; 胡友珠; 罗庆勇
338000江西，新余市人民医院神经外科（钟波、邹国荣、张冬根、胡友珠、罗庆勇）
Author(s):
ZHONG Bo;  ZOU Guo-rong;  ZHANG Dong-gen;  HU You-zhu;  LUO Qing-yong
Department of Neurosurgery, Xinyu Hospital Affiliated to Nanchang University, Xinyu 338000, China
关键词:
高血压性脑出血; 基底节区; 显微手术; 经侧裂-岛叶入路; 经皮层入路; 疗效
Keywords:
Hypertensive cerebral hemorrhage;  Basal ganglia;  Microsurgery;  Transsylvian-insular approach;  Transcortical approach;  Clinical efficacy
分类号:
R 743.34; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2024.05.003
文献标志码:
A
摘要:
目的 对比分析经侧裂-岛叶入路和经皮层入路手术治疗高血压基底节区出血的疗效。方法 回顾性分析2018年9月至2022年6月手术治疗的86例高血压性基底节区出血的临床资料。36例经侧裂-岛叶入路手术（观察组），50例经皮层入路手术（对照组）。术后24 h内复查CT计算血肿残存率，术后3、12个月采用GOS评分评定预后；术后12个月进行言语功能测定。结果 观察组术后24 h血肿残余率（16.7%，6/36）明显低于对照组（44.0%，22/50；P<0.05）；观察组术后3、12个月GOS评分[分别为（3.42±0.50）分、（4.24±0.44）分]均明显优于对照组[分别为（3.04±0.40）、（3.78±0.42）分；P<0.05）；观察组术后12个月言语功能恢复良好率（84.8%，28/33）明显优于对照组（60.4%，26/43；P<0.05）。结论 与皮层入路手术相比，经侧裂-岛叶入路手术清除基底节区出血创伤小，血肿残存率低，言语功能可得到良好保护，能最大限度保护病人神经功能并显著改善病人的预后。
Abstract:
Objective To compare the clinical efficacy of surgery through transsylvian-insular approach and transcortical approach for patients with hypertensive basal ganglia hemorrhage (HBGH). Methods The clinical data of 86 patients with HBGH underwent surgery from September 2018 to June 2022 were retrospectively analyzed. Thirty-six patients underwent surgery through transsylvian-insular approach (observation group) and 50 patients underwent surgery through transcortical approach (control group). The rate of hematoma retation was calculated by CT within 24 h after surgery, and the prognosis was assessed by GOS score at 3 and 12 months after surgery. Speech function was tested 12 months after operation. Results The residual rate of hematoma 24 h after operation in the observation group (16.7%, 6/36) was significantly lower than that (44.0%, 22/50) in the control group (P<0.05). The GOS scores of the observation group at 3 and 12 months after operation [(3.42±0.50) points and (4.24±0.44) points, respectively]were significantly better than those [(3.04±0.40) points and (3.78±0.42) points, respectively]of the control group (P<0.05). The rate of good speech function recovery 12 months after operation in the observation group (84.8%, 28/33) was significantly higher than that (60.4%, 26/43) in the control group (P<0.05). Conclusions Compared with surgery through transcortical approach for patients with HBGH, surgery through transsylvian-insular approach has less trauma and lower residual rate of hematoma, better protection of speech function, maximum protection of neurological function and significant improvement of patient prognosis.

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备注/Memo

备注/Memo:
（2023-05-29收稿，2024-02-18修回）
基金项目：江西省新余市科技计划项目（20223090862）
通信作者：邹国荣，Email：zgr3z369@163.com
更新日期/Last Update: 2024-05-30