Clinical Effect of Microscopic Trans-lateral Fissure Approach and the Middle Temporal Gyrus Fistula Approach for Hematoma Removal in the Treatment of Cerebral Hemorrhage
Objective:To investigate the effect of microscopic trans-lateral fissure approach and middle temporal gyrus fistula approach for hematoma removal in the treatment of cerebral hemorrhage.Method:From January 2021 to January 2023,86 patients with cerebral hemorrhage were selected from Jian'ou Municipal Hospital,the patients were divided into control group(middle temporal gyrus fistula approach)and observation group(microscopic trans-lateral fissure approach),with 43 cases in each group.Operation time,blood loss,time to get out of bed,hematoma clearance rate,inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),procalcitonin(PCT),C-reactive protein(CRP)],neurofactors[neuron-specific enolase(NSE),neurotrophic factor(NF),S100B protein,D-dimer],stress index[malondialdehyde(MDA),superoxide dismutase(SOD),lipid peroxidation product(LPO),glutathione peroxidase(GSH-Px)],prognosis were compared between the two groups.Result:Operation time,blood loss,getting out of bed time and hematoma clearance rate in observation group were better than those in control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in IL-6,TNF-α,PCT and CRP levels between the two groups(P>0.05).After operation,the levels of IL-6,TNF-α,PCT and CRP in both groups were increased,but the levels in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in the levels of NSE,NF,S100B protein and D-dimer between the two groups(P>0.05).After operation,the levels of NSE,NF,S100B protein and D-dimer were decreased in both groups,and the levels in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in MDA,SOD,LPO and GSH-Px levels between the two groups(P>0.05).After operation,the levels of MDA,SOD,LPO and GSH-Px were increased in both groups,but the levels of MDA and LPO in the observation group were lower than those in the control group,and the levels of SOD and GSH-Px were higher than those in the control group,the differences were statistically significant(P<0.05).The good prognosis rate of the control group was lower than that of the observation group,the difference was statistically significant(P<0.05).There was no significant difference in mortality between the two groups(P>0.05).Conclusion:Microscopic trans-lateral fissure approach for hematoma removal in the treatment of cerebral hemorrhage can improve the clearance rate of hematoma,reduce inflammation and nerve function injury,and facilitate the prognosis of patients.
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