超早期经颞锁孔入路与经脑沟裂自然间隙入路的自发性脑出血的显微手术治疗
Microsurgical Treatment of Spontaneous Intracerebral Hemorrhage:Comparison of Super Early Transtemporal Lock Hole Approach and Natural Gap Approach
左娜 1郭延莉 1田永娟1
作者信息
- 1. 南阳市中心医院神经外科,河南 南阳 473000
- 折叠
摘要
目的 探讨自发性脑出血的显微手术治疗:超早期经颞锁孔入路与经脑沟裂自然间隙入路的比较.方法 选取2021年12月—2022年12月68 例自发性脑出血患者为研究对象,采用数字表法随机分为对照组(n=34)和观察组(n=34),对照组给予经脑沟裂入路手术,观察组给予经颞锁孔入路手术,比较两组患者手术情况、术后并发症、手术前后的炎症因子水平及临床神经功能缺损量表(NDS)评分.结果 观察组失血量、手术时长与对照组相比差异无统计学意义(P＞0.05),而在血肿清除时间、脑脊液恢复时间、置管引流时间、住院时长上均短于对照组,差异有统计学意义(P＜0.05).观察组患者的并发症,包括颅内感染、出血再发、脑脊液漏、术后脑水肿的发生率均明显低于对照组,差异有统计学意义(P＜0.05).术前,两组hs-CRP、IL-6、IL-10水平比较差异无统计学意义(P＞0.05);术后,观察组hs-CRP、IL-6、IL-10水平均低于对照组,差异有统计学意义(P＜0.05).术后两组患者的NDS评分比较,差异有统计学意义(P＜0.05).结论 超早期经颞锁孔入路的自发性脑出血的显微手术的治疗效果显著,有利于患者神经功能恢复,安全性可,值得推广应用.
Abstract
Objective To investigate the microsurgical treatment of spontaneous intracerebral hemorrhage:a comparative approach between the ultra early temporal keyhole approach and the natural space approach through the sulci fissure.Methods From December 2021 to December 2022,68 patients with spontaneous intracerebral hemorrhage were selected as research objects,and randomly divided into control group(n=34)and observation group(n=34)by digital table method.The control group was given transsulci approach surgery,and the observation group was given transtemporal keyhole approach surgery.The surgical status,postoperative complications,levels of inflammatory factors before and after surgery and clinical neurological deficit scale(NDS)scores were compared between the two groups.Results The blood loss and operation duration of the observation group were not significantly different from those of the control group(P＞0.05),while the hematoma clearance time,cerebrospinal fluid recovery time,catheter drainage time and hospitalization duration were shorter than those of the control group,with statistical significance(P＜0.05).Compared with the control group,the incidence of surgical complications in the observation group,including intracranial infection,recurrence of hemorrhage,cerebrospinal fluid leakage,postoperative brain edema,etc.,were significantly reduced,with statistical significance(P＜0.05).Before operation,there were no differences in hs-CRP,IL-6 and IL-10 indexes between the two groups(P＞0.05).After operation,the indexes of the observation group were lower than those of the control group,and the difference between the groups was statistically significant(P＜0.05).The NDS scores of the two groups were compared after operation,and the difference was statistically significant(P＜0.05).Conclusion Ultra-early microsurgery through temporal keyhole approach for spontaneous intracerebral hemorrhage is effective,beneficial to the recovery of neurological function,safe,worthy of popularization and application.
关键词
自发性脑出血/超早期经颞锁孔入路/经脑沟裂自然间隙入路Key words
spontaneous cerebral hemorrhage/ultra early temporal keyhole approach/natural space approach via sulci fissure引用本文复制引用
出版年
2024
NETL
NSTL
万方数据