CAJ | 학술논문

目的探讨经侧裂-岛叶入路显微手术对基底节区高血压脑出血的疗效。方法回顾性分析2010年1月-2013年6月64例基底节高血压脑出血患者临床资料。其中41例行经侧裂-岛叶入路显微手术（ A组）；另23例行常规骨瓣开颅手术（ B组），比较2组治疗效果及近远期预后。结果 A组手术时间（115妸．35±46．23） min、术后自动睁眼时间（5．22±3．43）h均短于B组（212．43±58．24）min、（8．74±4．51）h（ P ＜0．05）。术后7 d A组GCS评分（11．92±2．73）分高于B组（9．85±2．46）分（ P ＜0．05）。术后48 h行CT复查，A组血肿大部分清除率为80．49％（33/41）优于B组的56．52％（13/23）（ P ＜0．05）。观察组与对照组并发症发生率无明显差异（39．02％vs ．47．83％， P ＞0．05）。术后3个月随访，A组优良率为60．98％（25/41），明显高于B 组的34．78％（8/23）（ P ＜0．05）。术后12个月随访，A组优良率为72．50％（29/40），明显高于B组的47．62％（10/21）（ P ＜0．05）。结论经侧裂-岛叶入路显微手术治疗脑出血是一种损伤小、疗效好、并发症少的治疗方法。
목적탐토경측렬-도협입로현미수술대기저절구고혈압뇌출혈적료효。방법회고성분석2010년1월-2013년6월64례기저절고혈압뇌출혈환자림상자료。기중41례행경측렬-도협입로현미수술（ A조）；령23례행상규골판개로수술（ B조），비교2조치료효과급근원기예후。결과 A조수술시간（115아．35±46．23） min、술후자동정안시간（5．22±3．43）h균단우B조（212．43±58．24）min、（8．74±4．51）h（ P ＜0．05）。술후7 d A조GCS평분（11．92±2．73）분고우B조（9．85±2．46）분（ P ＜0．05）。술후48 h행CT복사，A조혈종대부분청제솔위80．49％（33/41）우우B조적56．52％（13/23）（ P ＜0．05）。관찰조여대조조병발증발생솔무명현차이（39．02％vs ．47．83％， P ＞0．05）。술후3개월수방，A조우량솔위60．98％（25/41），명현고우B 조적34．78％（8/23）（ P ＜0．05）。술후12개월수방，A조우량솔위72．50％（29/40），명현고우B조적47．62％（10/21）（ P ＜0．05）。결론경측렬-도협입로현미수술치료뇌출혈시일충손상소、료효호、병발증소적치료방법。
Objective To investigate the curative effect of the transsylvian insular approach , microsurgical operation on hypertensive cerebral hemorrhage in basal ganglion .Methods From 2010 January to 2013 June, a retrospective analysis the clinical data of 64 cases hypertensive cerebral hemorrhage were performed .Among them, 41 cases underwent lateral fis-sure and insula microsurgical operation ( group A ); the other 23 underwent conventional craniotomy operation ( group B ) , compare the therapeutic effect of 2 groups and the short -and long-term prognosis .Results The operation time of group A was (115.35 ±46.23) min, automatic opening eye time after operation was (5.22 ±3.43) h, which were all shorter than in the B group’s (212.43 ±58.24) min, and (8.74 ±4.51)h ( P <0.05).After 7 d, group A’s GCS score was (11.92 ± 2.73) points, which is higher than that in group B with (9.85 ±2.46) points ( P <0.05).After 48 h’s CT examination re-vealed that, group A’s most hematoma clearance rate was 80.49%(33/41), which is better than that of B group ’s 56.52%(13/23) ( P <0.05).The observation group had no significant difference with the control group in the incidence of compli -cations (39.02%vs.47.83%, P >0.05).Followed up after operation for 3 months, in group A, the excellent and good rate was 60.98%(25/41), significantly higher than that of group B ’s 34.78%(8/23) ( P <0.05).Followed up for 12 months after operation, in group A, the excellent and good rate was 72.50%(29/40), significantly higher than that of group B’s 47.62%(10/21) ( P <0.05).Conclusion Through lateral fissure and insula microsurgical operation for treatment of brain hemorrhage is less injury , good efficacy and less complications .