经侧裂岛叶入路显微手术治疗高血压基底核区出血的临床效果

摘要

Objective To explore the clinical effect of transsylvian transinsular approach microsurgery on hypertensive basal ganglia hemorrhage.Methods A total 195 patients with hypertensive basal ganglia hemorrhage were selected in the Third People's Hospital of Mianyang from Januany 2016 to Januany 2017,and they were divided into control group (n=97)and observation group(n=98)according to the therapeutic regimens. Patients in control group received transtemporal cortex approach microsurgery,while patients in observation group received transsylvian transinsular approach microsurgery. Hematoma clearance rate,duration of surgery,postoperative automatic eye-open time,serum levels of S-100B and NSE before and after surgery,and incidence of postoperative complications were compared between the two groups.Results Hematoma clearance rate in observation group was statistically significantly higher than that in control group(P<0.05).Duration of surgery in observation group was statistically significantly longer than that in control group,while postoperative automatic eye-open time in observation group was statistically significantly shorter than that in control group(P<0.05). No statistically significant differences of serum level of S-100B or NSE was found between the two groups before surgery(P>0.05),while serum levels of S-100B and NSE in observation group were statistically significantly lower than those in control group after surgery(P<0.05). Incidence of postoperative complications in observation group was statistically significantly lower than that in control group (P<0.05).Conclusion Transsylvian transinsular approach microsurgery can effectively improve the hematoma clearance rate,shorten the postoperative automatic eye-open time,reduce the brain tissue injury and risk of postoperative complications in patients with hypertensive basal ganglia hemorrhage.%目的 探讨经侧裂岛叶入路显微手术治疗高血压基底核区出血的临床效果.方法 选取2016年1月—2017年1月绵阳市第三人民医院收治的高血压基底核区出血患者195例,根据治疗方案分为对照组97例与观察组98例.对照组患者行经颞叶皮质入路显微手术,观察组患者行经侧裂岛叶入路显微手术.比较两组患者血肿清除率、手术时间、术后自动睁眼时间、手术前后血清S-100B及神经元特异性烯醇化酶(NSE)水平、并发症发生情况.结果 观察组患者血肿清除率高于对照组(P<0.05).观察组患者手术时间长于对照组,术后自动睁眼时间短于对照组(P<0.05).术前两组患者血清S-100B、NSE水平比较,差异无统计学意义(P>0.05);术后观察组患者血清S-100B、NSE水平低于对照组(P<0.05).观察组患者并发症发生率低于对照组(P<0.05).结论 经侧裂岛叶入路显微手术可有效提高高血压基底核区出血患者血肿清除率,缩短术后自动睁眼时间,减轻脑组织损伤,降低并发症发生率.