昆明医科大学学报2024，Vol.45Issue(7)：56-61,6.DOI:10.12259/j.issn.2095-610X.S20240708
不同入路显微镜手术治疗青年重症基底节区高血压脑出血的疗效比较
Comparison of Effect of Microscopic Surgery via Different Approaches in Treatment of Young Patients with Severe Hypertensivebasal Ganglia Hemorrhage
摘要
Abstract
Objective To compare the effect of different approaches of microscopic surgery in the treatment of severe hypertensivebasal ganglia hemorrhage(HBGH)in young patients.Methods A retrospective analysis was performed on young patients with severe HBGH admitted to the department of Neurosurgery of Ankang Central Hospital from July 2017 to June 2023.According to the different surgical approaches,the patients were divided into a lateral fissure group(microscopic hematoma removal via lateral fissure approach)and a middle temporal gyrus group(microscopic hematoma removal via middle temporal gyrus approach).According to the propensity matching score method(caliper=0.02),the confounding factors were excluded,and 40 patients were obtained in each group.The hematoma clearance rate,perioperative indicators(surgical time,intraoperative blood loss,hospital stay,re-hemorrhage rate),incidence rates of complications,preoperative and postoperative serum indicators at 3 months[neuron specific enolase(NSE),S-100 protein],prognosis status(GOS)at 3 months after surgery and symptom improvement[modified Rankin scale(mRS),activity of daily living(ADL)]at 3 and 6 months after surgery were compared between the two groups.Results Within 24 hours after surgery,the hematoma clearance rate in lateral fissure group was significantly better than that in the middle temporal gyrus group(P<0.05).There were no significant differences in the surgical time and re-hemorrhage rate between both groups(P>0.05),but the intraoperative blood loss and hospital stay in the lateral fissure group were significantly less or shorter than those in the middle temporal gyrus group(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).At 3 months after surgery,NSE and S100 in both groups of patients significantly decreased(P<0.05),and the lateral fissure group was significantly lower than the middle temporal gyrus group(P<0.05).After 3 months of surgery,the GOS grading of the lateral fissure group was significantly better than that of the middle temporal gyrus group(P<0.05).At 3 and 6 months after surgery,the mRS in the two groups decreased gradually(P<0.05)while the ADL increased gradually(P<0.05).The mRS in the lateral fissure group was significantly lower(P<0.05)while the ADL was significantly higher than that in the middle temporal gyrus group(P<0.05).Conclusion Compared with the middle temporal gyrus approach,the lateral fissure approach in the treatment of severe HBGH has a higher hematoma removal rate,shorter surgical time,less blood loss and better prognosis of patients.关键词
重症基底节区高血压脑出血/血肿清除术/开颅术Key words
Severe hypertensive basal ganglia hemorrhage/Hematoma removal/Craniotomy分类
医药卫生引用本文复制引用
王坤,蒲军,杨涛,王路,李东波..不同入路显微镜手术治疗青年重症基底节区高血压脑出血的疗效比较[J].昆明医科大学学报,2024,45(7):56-61,6.基金项目
国家自然科学基金资助项目(82160512) （82160512）
