Objective To compare the clinical efficacy of surgery through transsylvian-insular approach and transcortical approach for patients with hypertensive basal ganglia hemorrhage(HBGH).Methods The clinical data of 86 patients with HBGH underwent surgery from September 2018 to June 2022 were retrospectively analyzed.Thirty-six patients underwent surgery through transsylvian-insular approach(observation group)and 50 patients underwent surgery through transcortical approach(control group).The rate of hematoma retation was calculated by CT within 24 h after surgery,and the prognosis was assessed by GOS score at 3 and 12 months after surgery.Speech function was tested 12 months after operation.Results The residual rate of hematoma 24 h after operation in the observation group(16.7%,6/36)was significantly lower than that(44.0%,22/50)in the control group(P<0.05).The GOS scores of the observation group at 3 and 12 months after operation[(3.42±0.50)points and(4.24±0.44)points,respectively]were significantly better than those[(3.04±0.40)points and(3.78±0.42)points,respectively]of the control group(P<0.05).The rate of good speech function recovery 12 months after operation in the observation group(84.8%,28/33)was significantly higher than that(60.4%,26/43)in the control group(P<0.05).Conclusions Compared with surgery through transcortical approach for patients with HBGH,surgery through transsylvian-insular approach has less trauma and lower residual rate of hematoma,better protection of speech function,maximum protection of neurological function and significant improvement of patient prognosis.
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