[1]常志锋 王 梅 岳常义 崔永梅.经侧裂入路与经颞部皮质入路显微手术治疗高血压性基底节区出血的效果分析[J].中国临床神经外科杂志,2020,(04):221-222.[doi:10.13798/j.issn.1009-153X.2020.04.010]
 CHANG Zhi-feng,WANG Mei,YUE Chang-yi,et al.Effect of microsurgery on hypertensive basal ganglia hemorrhage: translateral fissure approach versus transtemporal cortical approach[J].,2020,(04):221-222.[doi:10.13798/j.issn.1009-153X.2020.04.010]
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经侧裂入路与经颞部皮质入路显微手术治疗高血压性基底节区出血的效果分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年04期
页码:
221-222
栏目:
论著
出版日期:
2020-04-30

文章信息/Info

Title:
Effect of microsurgery on hypertensive basal ganglia hemorrhage: translateral fissure approach versus transtemporal cortical approach
文章编号:
1009-153X(2020)04-0221-02
作者:
常志锋 王 梅 岳常义 崔永梅
473132 河南南阳,南阳油田总医院神经外科(常志锋、王 梅、岳常义、崔永梅)
Author(s):
CHANG Zhi-feng WANG Mei YUE Chang-yi CUI Yong-mei.
Department of Neurosurgery, Nanyang Oilfield General Hospital, Nanyang 473132, China
关键词:
高血压性脑出血基底节区血肿清除术经侧裂入路经颞部皮质入路
Keywords:
Hypertensive basal ganglia hemorrhage Microsurgery Lateral fissure approach transtemporal cortical approach
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2020.04.010
文献标志码:
A
摘要:
目的 对比分析经侧裂入路与经颞部皮质入路显微手术治疗高血压性基底节区出血的疗效。方法 回顾性分析2016年1月至2019年1月收治的50例高血压性基底节区出血的临床资料。经侧裂入路手术25例(侧裂组),经颞部入路手术25例(颞部组)。结果 两组手术时间、术中出血量、术后意识恢复时间均无统计学差异(P>0.05)。侧裂组血肿清除率(96.00%,24/25)明显高于颞部组(68.00%,17/25;P<0.05)。侧裂组再出率(4.00%,1/25)明显低于颞部组(32.00%,8/25;P<0.05)。侧裂组预后良好率(80.00%,20/25)明显高于颞部组(44.00%,11/25;P<0.05)。结论 与颞部皮质入路相比,经侧裂入路血肿清除术对高血压性基底节区出血的临床效果更佳,可显著提高血肿清除率,减少脑组织损伤,改善病人预后。
Abstract:
Objective To compare the effect of microsurgical treatment on hypertensive basal ganglia hemorrhage through lateral fissure approach and transtemporal cortical approach. Methods The clinical data of 50 patients with hypertensive basal ganglia hemorrhage who underwent surgery from January, 2016 to January, 2019 were retrospectively analyzed. Of these 50 patients, 25 patients reveive operation through lateral fissure approach (lateral fissure group) and 25 through temporal approach (temporal group). Results There was no statistical difference in operation time, intraoperative blood loss, and postoperative consciousness recovery time between both groups (P>0.05). The rate of hematoma evacuation in the lateral fissure group (96.00%, 24/25) was significantly higher than that (68.00%, 17/25) in the temporal group (P<0.05). The rate of rebleeding in the lateral fissure group (4.00%, 1/25) was significantly lower than that (32.00%, 8/25) in the temporal group (P<0.05). The good prognosis rate in the lateral fissure group (80.00%, 20/25) was significantly higher than that (44.00%, 11/25) in the temporal group (P<0.05). Conclusion Compared with the temporal cortical approach, the hematoma removal through the lateral fissure approach has better effects on hypertensive basal ganglia hemorrhage, which can significantly increase the hematoma evacuation rate, reduce brain tissue damage and improve the patient's prognosis.

参考文献/References:

[1] Lu TS, An CL, Guan JY. Clinical experience of individual surgical therapy in hypertensive basal ganglia hemorrhage [J]. J Neurosurg Sci, 2018, 62(2): 140-145.
[2] 张振兴,崔 禹,霍晓川,等. 基底节区脑出血的偏侧性与 左右利手的相关性[J]. 中国老年学杂志,2014,34(20): 5646-5647.
[3] 千 超,王建峰. 穿刺引流术治疗高血压性基底节区出疗 效分析[J]. 中国临床神经外科杂志,2018,23(1):33-34.
[4] 伍伟俊,谢德斌,贺建雄,等. 经外侧裂岛叶入路显微手术 治疗高血压性基底节区出血[J]. 中国临床神经外科杂 志,2017,22(11):775-776.
[5] 王兴铧,谢京晶,徐忠法. 中等量高血压性基底节区出血 的手术疗效分析[J]. 中国临床神经外科杂志,2017,22 (11):783-784.
[6] 祝广林,张 伟,齐鸿飞. 小骨窗经外侧裂入路手术治疗 高血压性基底节区出血并脑疝[J]. 中国临床神经外科杂 志,2018,23(4):266-267.
[7] 阮 航,杨国平,罗 明,等. 经额部和经颞部入路导航辅 助下内镜手术治疗高血压性基底节区出血的对比分析 [J]. 中国临床神经外科杂志,2017,22(10):693-694,697.
[8] Harsha KJ, Parameswaran K. Adult post-varicella small vessel vaculopathy mimicking hypertensive basal ganglia hemorrhage with coexisting infarcts [J]. Neurol India, 2016, 64(6): 1323-1326.
[9] 徐荣华,谢轩贵,张洪良,等. 早期开颅显微手术治疗高血 压基底节区脑出血106例临床研究[J]. 四川医学,2018, 39(1):24-27.
[10] 李红闪,史彦芳,郭 毅,等. 经侧裂-岛叶入路小骨窗显 微手术治疗高血压性基底节区出血[J]. 中国临床神经外 科杂志,2016,21(12):777-778.
[11] 何明亮,黄浩炜,何永通,等. 额部和颞部钻孔引流术治疗 基底节区高血压脑出血的疗效[J]. 中国临床神经外科杂 志,2015,20(6):376-377.
[12] 林 晖,吴光辉,刘美秋. 经中央沟下点入路显微手术治 疗优势半球高血压性基底节区出血[J]. 中国临床神经外 科杂志,2018,23(10):659-661.
[13] 周达全,彭 鹏,胡克琦,等. 经颞部和额部入路微创钻孔 引流治疗中等量基底节区高血压性脑出血临床对比[J]. 中国临床研究,2017,30(6):798-800.
[14] 马 俊,周 勇,马元施,等. 经外侧裂-岛叶入路显微手 术治疗高血压性基底节区出血的疗效分析[J]. 中国临床 神经外科杂志,2018,23(9):613-615.

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备注/Memo

备注/Memo:
(2019-08-14收稿,2019-11-28修回)
更新日期/Last Update: 2020-04-10