中国实用神经疾病杂志2025，Vol.28Issue(10)：1200-1205,6.DOI:10.12083/SYSJ.241300
显微镜下经侧裂岛叶入路血肿清除术与传统骨瓣开颅颞中回入路术治疗基底节区HICH对比研究
Comparison of microscopic hematoma removal via transsylvian transinsular approach and traditional bone flap craniotomy via middle temporal gyrus approach in the treatment of HICH in basal ganglia
摘要
Abstract
Objective To compare the effect and complications of microscopic hematoma removal via transsylvian transinsular approach(A operation)and traditional bone flap craniotomy via middle temporal gyrus approach(B operation)in the treatment of hypertensive intracerebral hemorrhage(HICH)in basal ganglia.Methods The clinical data of patients with HICH in basal ganglia treated in Shanghai Sixth People's Hospital from May 2021 to May 2024 were retrospectively analyzed.Forty-nine patients who underwent B operation were included in the control group,and 49 patients who underwent A operation were included in the observation group.The surgical conditions and postoperative complications were compared between the two groups.The cerebral oxygen metabolism indexes,brain neuron injury indexes and inflammation were compared before surgery and at 1 week after surgery.Results The intraopertive blood loss and consciousness recovery time in the observation group were lower or shorter than those of the control group,while the hematoma clearance rate and surgical time were higher or longer than those in the control group(P＜0.05).Within 1 week after surgery,there was no significant difference in the incidence of postoperative complications between the two groups(P＞0.05).At 1 week after surgery,jugular venous oxygen saturation(SjvO2)and brain-derived neurotrophic factor(BDNF)in both groups were higher than those before treatment,and SjvO2 and BDNF in the observation group were higher than those in the control group.The levels of cerebral extraction of oxygen(CEO2),arteriovenous oxygen difference(AVDO2),neuron-specific enolase(NSE),central nervous system specific protein(S100β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β)in both groups were lower than those before treatment,and which in the observation group were lower than those in the control group(P＜0.05).Conclusion Microscopic hematoma removal via transsylvian transinsular approach is effective in the treatment of HICH patients in basal ganglia,which can significantly improve the indexes of cerebral oxygen metabolism and brain neuron injury,and reduce the inflammation,and has good safety.关键词
高血压性脑出血/基底节区/显微镜/经侧裂岛叶入路/血肿清除术/骨瓣开颅颞中回入路/并发症Key words
Hypertensive intracerebral hemorrhage(HICH)/Basal ganglia region/Microscopy/Transsylvian transinsular approach/Hematoma removal/Bone flap craniotomy via middle temporal gyrus approach/Complications分类
医药卫生引用本文复制引用
张爱军,鲁友明,陈鑫,袁磊,邹冬冬..显微镜下经侧裂岛叶入路血肿清除术与传统骨瓣开颅颞中回入路术治疗基底节区HICH对比研究[J].中国实用神经疾病杂志,2025,28(10):1200-1205,6.基金项目
上海市卫生和计划生育委员会科研课题(编号:201440306) （编号:201440306）
