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目的分析侧裂入路手术治疗高血压自发性脑出血的近期疗效及并发症情况。方法 2013年6月~2016年1月行侧裂入路手术的54例高血压自发性脑出血患者为治疗组,选择同期行颞叶皮质入路手术的50例高血压自发性脑出血患者为对照组,比较两组围术期相关指标、血肿清除率、术后并发症及术后6个月预后情况。结果平均手术时间、术中出血量、术后意识恢复时间方面,治疗组均明显少于对照组(P<0.05);血肿清除方面,治疗组血肿清除>90%比率70.37%显著高于对照组的50.00%(P<0.05);治疗组并发症发生率7.40%显著低于对照组的30.00%(P<0.05);治疗组术后6个月预后良好率70.37%显著高于对照组的42.00%,差异有统计学意义(P<0.05)。结论相比颞叶皮质入路手术,侧裂入路显微手术治疗高血压自发性脑出血具有创伤小、血肿清除率高、术后并发症少、近期预后良好特点。
Objective To analyze the short-term curative effect and complications of surgical treatment of spontaneous hypertensive cerebral hemorrhage by lateral fissure approach. Methods From June 2013 to January 2016, 54 patients with hypertensive spontaneous intracerebral hemorrhage undergoing lateral fissure approach were selected as the treatment group. Fifty patients with spontaneous hypertensive cerebral hemorrhage who underwent temporal cortex approach during the same period were Control group, the two groups were compared perioperative indicators, hematoma clearance, postoperative complications and prognosis after 6 months. Results The average operation time, intraoperative blood loss and postoperative recovery time were significantly less in the treatment group than in the control group (P <0.05). In the hematoma removal group, the hematoma clearance rate> 90% was 70.37% in the treatment group was significantly higher than that in the control group (P <0.05). The incidence of complications in the treatment group was significantly lower than that in the control group (7.40% vs 30.00%, P <0.05). The good prognosis was 70.37% in the treatment group at 6 months after operation %, The difference was statistically significant (P <0.05). Conclusion Microsurgery for the treatment of spontaneous hypertensive cerebral hemorrhage has the advantages of less trauma, higher hematoma clearance rate, less postoperative complications and better prognosis than temporal lobe cortical approach.