高血压基底节脑出血两种手术入路血肿清除效果比较

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Abstract Objective To compare the hematoma removal effect of trans-sylvian insular approach and ventriculostomy through middle frontal gyrus approach in hypertensive basal ganglia hemorrhage (HBGH) patients.Methods One hundred and eight patients with HBGH treated in Beijing Changping Hospital from October 2019 to January 2022 were divided into two groups according to surgical treatments, with 54 cases underwent trans-sylvian insular approach (control group) and ventriculostomy through middle frontal gyrus approach (observational group), respectively. The operation time (OT), postoperative recovery time (PRT), hematoma clearance rate (HCR), operation-related complication (ORC), and Glasgow Outcome Scale (GOS) 3 months after surgery of the two groups were compared.Results The hematoma clearance rate in the observational group was 91.63%±0.77%, which was significantly higher than that in the control group (82.82%±2.62%) (P<0.05). The cases with operation time, intraoperative bleeding loss, operation-related complication, and hospital staying of the observation group were significantly lower than those of the control group, while GOS 3 months after surgery were significantly higher than that of the control group (P<0.05).Conclusion The ventriculostomy through middle frontal gyrus approach is more convenient than trans-sylvian insular approach in hematoma removal of HBGH patients, especially in shortening operation, reducing postoperative complication, and improving hematoma effect and neurological prognosis.

Key words： ventriculostomy through middle frontal gyrus approach trans-sylvian insular approach hypertensive basal ganglia hemorrhage hematoma evacuation minimally invasive

Received: 21 March 2022

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	SUN Jian
	HONG Shunming
	DU Haibin
	LI Jianqiang

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SUN Jian,HONG Shunming,DU Haibin等. Comparison of hematoma removal effect of two approaches in patients with hypertensive basal ganglia hematoma[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(7): 590-593.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2022/V33/I7/590

[1]	蒋小兵, 高文文, 赵海康. 高血压脑出血术后再出血危险因素的Meta分析[J]. 临床神经外科杂志, 2021, 18 (2): 209-213.
[2]	Dastur C K, Yu W. Current management of spontaneous intracerebral haemorrhage[J]. Stroke Vasc Neurol, 2017, 2 (1): 21-29.
[3]	中华医学会神经外科学分会, 中国医师协会急诊医师分会, 中华医学会神经病学分会脑血管病学组, 国家卫健委脑卒中筛查与防治工程委员会. 高血压性脑出血中国多学科诊治指南[J]. 中国急救医学, 2020, 40 (8): 689-702.
[4]	骆明涛, 游潮, 贺民,等. 《高血压性脑出血中国多学科诊治指南》急救诊治解读[J]. 中国急救医学, 2021, 41 (3): 185-190.
[5]	谢军,王振国, 张兴平,等. 神经内镜颅内血肿清除术和软通道血肿穿刺引流术治疗高血压性脑出血的临床对比研究[J]. 中西医结合心脑血管病杂志, 2021, 19 (9): 1562-1565.
[6]	傅强, 张一帆, 连建中. 改良-立体定向软通道微创颅内血肿清除术与外科大骨瓣开颅对高血压脑出血患者的疗效及分析[J]. 贵州医药, 2021, 45 (10): 1542-1543.
[7]	Tang Y, Lv Z, Li X, et al. Efficacy and safety of minimal invasive surgery treatment in hypertensive intracerebral hemorrhage: a systematic review and meta-analysis[J]. BMC Neurol, 2018, 18 (1): 136.
[8]	任振强, 史永涛, 彭飞. 经侧裂-岛叶入路显微手术与常规大骨瓣开颅血肿清除术治疗高血压性基底核区脑出血效果对比观察[J]. 青岛医药卫生, 2019, 51 (2): 90-93.
[9]	Oliveira A L. Surgery for spontaneous intracerebral hemorrhage[J]. Crit Care, 2020, 24 (1): 45.
[10]	王如海, 谢时帅, 于强. mGS评分对高血压脑出血破入脑室患者术后不良结局预测价值[J]. 中国神经精神疾病杂志, 2020, 46 (7): 390-394.
[11]	Ikram M, Wieberdink R G, Koudstaal P J. International epidemiology of intracerebral hemorrhage[J]. Curr Atheroscler Rep, 2012, 14 (4): 300-306.
[12]	肖健齐, 吴安华, 王运杰,等. 中国汉族人群高血压脑出血患者NFATC1基因rs754093多态性观察[J]. 山东医药, 2011, 51 (2): 7-9.
[13]	赵继宗, 周定标, 周良辅,等. 2464例高血压脑出血外科治疗多中心单盲研究[J]. 中华医学杂志, 2005, 85 (32): 2238-2242.
[14]	张荣军, 王晓峰, 唐宗椿,等. 6374例高血压脑出血患者临床特点的分析及治疗方法的选择[J]. 中华神经医学杂志, 2013, 12 (1): 57-61.
[15]	刘宏浩, 黄程, 李毅毅,等. 不同手术时机治疗高血压脑出血的对比分析研究[J]. 重庆医学, 2014, (22): 2925-2927.
[16]	魏小兵, 黄楚涛, 刘惜弟,等. 神经内镜微创颅内血肿清除术对脑出血血肿清除率的影响[J]. 现代科学仪器, 2021, 38 (6): 151-155.
[17]	Xu S, Lin Z, Zhang N, et al. Effect of integrated traditional Chinese and western medicine therapy for acute hypertensive intracerebral hemorrhage: a meta-analysis[J]. Artif Cells Nanomed Biotechnol, 2017, 45 (6): 1-6.
[18]	Xu X, Zhang J, Xu B, et al. Effectiveness of endoscopic surgery for supratentorial hypertensive intracerebral hemorrhage: a comparison with craniotomy[J]. J Neurosurg, 2018, 128 (2): 553-559.
[19]	庞力, 周良辅. 微创手术治疗高血压脑出血的术式比较[J]. 中国微侵袭神经外科杂志, 2001, 6 (3): 147-150.
[20]	胡荣, 冯华. 典型脑疾病-自发性脑出血研究进展与新理念[J]. 科技导报, 2017, 35 (4): 18-22.
[21]	屈洪涛, 秦华平, 杨昊,等. 神经内镜辅助下小骨瓣微创治疗高血压脑出血[J]. 临床神经外科杂志, 2013, 10 (3): 169-171.
[22]	Yuanliang Y, Jian H Zhenhui Z, et al. Endoscopic surgery without decompressive craniectomy in large putaminal intracerebral hemorrhage: assessment of efficacy and safety[J]. Neurocritical Care, 2020, 32 (2): 392-399.
[23]	伍伟俊, 李平根, 李伯和,等. 外侧裂-岛叶入路与颞叶皮质入路治疗高血压性基底节区脑出血的疗效比较[J]. 南昌大学学报(医学版), 2020, 60 (1): 48-51.
[24]	查显斌, 冯凌云, 张金鹏. 经外侧裂-岛叶入路手术对基底节区高血压脑出血患者预后的影响[J]. 贵州医药, 2020, 44 (9): 1385-1386.
[25]	崔永华, 韩清, 陈恒林,等. 微骨瓣额中回入路治疗重型脑室出血[J]. 天津医药, 2014, (2): 179-181.
[26]	胡爱民, 薛志敏, 刘哲宁. 情感障碍患者内侧前额叶-杏仁核异常的神经生物机制研究进展[J]. 中华精神科杂志, 2016, 49 (6): 414-417.

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