中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2013年
8期
817-820
,共4页
唐晓平%游潮%张涛%彭华%赵龙%杨彬彬%印晓鸿%段军伟%漆建
唐曉平%遊潮%張濤%彭華%趙龍%楊彬彬%印曉鴻%段軍偉%漆建
당효평%유조%장도%팽화%조룡%양빈빈%인효홍%단군위%칠건
脑出血%壳核%外科治疗%外侧裂岛叶入路%颞叶皮质入路
腦齣血%殼覈%外科治療%外側裂島葉入路%顳葉皮質入路
뇌출혈%각핵%외과치료%외측렬도협입로%섭협피질입로
Cerebral hemorrhage%Putamianal%Neurosurgical treatment%Lateral fissure-insula lobe approach%Temporal lobe cortex approach
目的 比较分析经外侧裂岛叶入路和经颞叶皮质入路两种手术方式治疗壳核出血的优劣性.方法 选择符合标准的壳核出血病例732例,随机分为A组和B组,A组经外侧裂岛叶进入血肿腔,B组经颞叶皮质进入血肿腔.对两组术前临床资料、手术操作、血肿清除量与再出血情况进行比较.结果 (1)两组术前情况比较,差异无统计学意义.(2)手术操作比较,经外侧裂岛叶入路进入血肿腔更容易、血肿残腔止血更顺利、对意外发现血管病变处理更方便、去骨瓣减压病例数更少,两组比较差异有统计学意义(P＜0.01).(3)经侧裂岛叶入路清除血肿95％以上的例数较经颞叶入路为多,再出血例数较经颞叶入路为少,两组比较差异有统计学意义(P＜0.01).结论 手术清除脑壳核血肿,经侧裂岛叶入路较经颞叶皮质入路更符合微创理念,值得临床推广.
目的 比較分析經外側裂島葉入路和經顳葉皮質入路兩種手術方式治療殼覈齣血的優劣性.方法 選擇符閤標準的殼覈齣血病例732例,隨機分為A組和B組,A組經外側裂島葉進入血腫腔,B組經顳葉皮質進入血腫腔.對兩組術前臨床資料、手術操作、血腫清除量與再齣血情況進行比較.結果 (1)兩組術前情況比較,差異無統計學意義.(2)手術操作比較,經外側裂島葉入路進入血腫腔更容易、血腫殘腔止血更順利、對意外髮現血管病變處理更方便、去骨瓣減壓病例數更少,兩組比較差異有統計學意義(P＜0.01).(3)經側裂島葉入路清除血腫95％以上的例數較經顳葉入路為多,再齣血例數較經顳葉入路為少,兩組比較差異有統計學意義(P＜0.01).結論 手術清除腦殼覈血腫,經側裂島葉入路較經顳葉皮質入路更符閤微創理唸,值得臨床推廣.
목적 비교분석경외측렬도협입로화경섭협피질입로량충수술방식치료각핵출혈적우렬성.방법 선택부합표준적각핵출혈병례732례,수궤분위A조화B조,A조경외측렬도협진입혈종강,B조경섭협피질진입혈종강.대량조술전림상자료、수술조작、혈종청제량여재출혈정황진행비교.결과 (1)량조술전정황비교,차이무통계학의의.(2)수술조작비교,경외측렬도협입로진입혈종강경용역、혈종잔강지혈경순리、대의외발현혈관병변처리경방편、거골판감압병례수경소,량조비교차이유통계학의의(P＜0.01).(3)경측렬도협입로청제혈종95％이상적례수교경섭협입로위다,재출혈례수교경섭협입로위소,량조비교차이유통계학의의(P＜0.01).결론 수술청제뇌각핵혈종,경측렬도협입로교경섭협피질입로경부합미창이념,치득림상추엄.
Objective To compare the neurosurgical treatment for putamianal hemorrhage through lateral fissure-insula lobe approach and temporal lobe cortex approach.Methods 732 cases of cerebral hemorrhage in putamianal area were selected and randomly assigned into group A and group B.The remove of hematoma in group A and group B was adopted by lateral fissure-insular cortex approach and temporal cortex approach,respectively.The preoperative clinical data,surgical operating conditions,removed volume of hematoma and re-bleeding incidence were compared between the two groups.Results (1) No significant differences were found in preoperative conditions between the two groups.(2) Compared with temporal lobe cortex approach,lateral fissure-insula lobe approach has more merits,such as easier to go into the hematoma cavity and stop bleeding,more convenience to deal with some vascular lesions and less cases of decompressive raniectomy(P ＜0.01).(3) Compared with temporal lobe cortex approach,there were more cases for their hematoma could be cleared over 95％,and less re-bleeding incidence via lateral fissure-insula lobe approach(P ＜ 0.01).Conclusions To remove putamianal hematoma via lateral fissure-insula lobe approach is more accordant with minimally invasive concept than that via temporal lobe cortex approach,and it is worth spreading widely in clinic.
