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目的探讨经侧裂入路显微手术治疗基底节区高血压脑出血与常规颅骨开瓣手术治疗的临床疗效差异。方法选取2013年12月至2016年6月我科治疗80例基底节区高血压脑出血患者,根据基底节区脑出血情况随机筛选,经侧裂入路显微手术治疗为实验组,常规颅骨开瓣手术治疗为对照组,观察比较两组并发症情况,患者日常生活能力(ADL)评估。结果实验组并发症率10%,对照组为35%,实验组明显低于对照组,差异有统计学意义(P<0.05)。实验组40例患者生存为38例,其中ADL 1~2级13例,3级15例,4级10例,死亡2例;对照组40例患者生存为36例,其中ADL 1~2级10例,3级11例,4级15例,死亡4例。实验组手术恢复疗效显著优于对照组,差异有统计学意义(P<0.05)。结论经侧裂入路显微手术有效清除治疗基底节区高血压脑,减轻神经细胞损伤,降低并发症发生率,值得临床广泛应用。
Objective To investigate the clinical effects of microsurgical treatment of lateral craniofacial microsurgery for treatment of hypertensive intracerebral hemorrhage in basal ganglia and conventional cranial flap surgery. Methods From December 2013 to June 2016, 80 patients with hypertensive intracerebral hemorrhage in basal ganglia were treated in our department. Patients were randomly selected according to the intracerebral hemorrhage in basal ganglia area. The experimental group was treated by microsurgical treatment of lateral fissure approach. The conventional skull Open surgery for the control group, observed and compared two groups of complications, patients with daily living (ADL) assessment. Results The complication rate was 10% in the experimental group and 35% in the control group, which was significantly lower in the experimental group than in the control group (P <0.05). The experimental group of 40 patients survived for 38 cases, including 13 cases of ADL grade 1 to 2, 15 cases of grade 3, 10 cases of grade 4, 2 deaths; 40 patients in the control group of 36 patients survived, of which ADL level 1 to 2 For example, grade 3 in 11 cases, grade 4 in 15 cases, and death in 4 cases. The recovery rate of the experimental group was significantly better than that of the control group, the difference was statistically significant (P <0.05). Conclusions Microsurgery via the lateral fissure approach can effectively remove the hypertensive brain in basal ganglia, reduce the damage of nerve cells and reduce the incidence of complications, which is worthy of clinical application.