CAJ | 학술논문

目的探讨经外侧裂及脑沟回裂入路治疗基底核区脑出血对减少术后并发症、改善预后的作用.方法利用尸头研究外侧裂以及额、颞叶部分脑沟的解剖,并回顾性分析经外侧裂入路手术治疗的14例、经脑沟回裂入路手术治疗的21例和经脑回皮层手术治疗的38例基底核区脑出血患者的临床资料.统计学分析明确3种方法是否具有可比性,并对比研究3种治疗方法的治疗效果.结果经脑外侧裂组与经脑沟回裂组预后差异无统计学意义(P＞0.05),两组与经颞叶皮层手术组比较差异均有统计学意义(P值均＜0.05),经外侧裂与经脑沟回裂入路较经脑回皮层入路血肿清除率高、术后恢复好、术后出现失语及癫痫可能性低.结论利用脑沟裂自然间隙入路治疗高血压基底核出血是切实可行的,且经外侧裂与经脑沟回裂入路手术优于经脑回皮质入路,该入路对正常脑组织损伤小、治疗效果好,对基底核出血可考虑首选.
목적 탐토경외측렬급뇌구회렬입로치료기저핵구뇌출혈대감소술후병발증、개선예후적작용.방법 이용시두연구외측렬이급액、섭협부분뇌구적해부,병회고성분석경외측렬입로수술치료적14례、경뇌구회렬입로수술치료적21례화경뇌회피층수술치료적38례기저핵구뇌출혈환자적림상자료.통계학분석명학3충방법시부구유가비성,병대비연구3충치료방법적치료효과.결과 경뇌외측렬조여경뇌구회렬조예후차이무통계학의의(P＞0.05),량조여경섭협피층수술조비교차이균유통계학의의(P치균＜0.05),경외측렬여경뇌구회렬입로교경뇌회피층입로혈종청제솔고、술후회복호、술후출현실어급전간가능성저.결론 이용뇌구렬자연간극입로치료고혈압기저핵출혈시절실가행적,차경외측렬여경뇌구회렬입로수술우우경뇌회피질입로,해입로대정상뇌조직손상소、치료효과호,대기저핵출혈가고필수선.
Objective To explore the therapeutic effects on cerebral hematomas in basal ganglia region via transsylvian fissure or cortical sulci in order to reduce the postoperative complications of the patient with cerebral hemorrhage.Methods To study the anatomy of transsylvian fissure and partial cortical sulci in frontal lobe and temporal lobe by using the heads of dead bodies.The clinical data of 14 patients with hypertensive basal ganglia hemorrhage treated via lateral fissure,21 patients with hypertensive basal ganglia hemorrhage treated via brain fold fissure approach and 38 patients with hypertensive basal ganglia hemorrhage treated via cortex were analyzed retrospectively.Results There was no difference in prognosis between the group via lateral fissure approach and the group via brain fold fissure approach (P ＞ 0.05).However,these two groups were different with the group via cortex in prognosis(all P values ＜0.05).Clearing intracerebral hematomas in basal ganglia region via fissure or cortical sulci-insular could occupy shorter operating time,get higher clearance rate of hematomas,gain better postoperative recovery,get lower occurrence rate of anepia and epilepsy after operation than through cortex.Conclusions It is feasible to treat intracerebral hematomas in basal ganglia region via transsylvian fissure or cortical sulci near lateral fissure which is the natural fissure in the brain.And it can treat cerebral hematomas in basal ganglia region effectively without heavy damage of normal brain tissue and can get satisfactory therapeutic efficacy.