中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2013年
2期
194-196
,共3页
黄波%邹国荣%胡友珠%陈自平
黃波%鄒國榮%鬍友珠%陳自平
황파%추국영%호우주%진자평
Toth水解剖技术%经侧裂入路%显微外科手术%高血压脑出血%基底节区
Toth水解剖技術%經側裂入路%顯微外科手術%高血壓腦齣血%基底節區
Toth수해부기술%경측렬입로%현미외과수술%고혈압뇌출혈%기저절구
Toth water dissection technique%Lateral fissure approach%Microsurgery%Hypertensive intracerebral hemorrhage%Basal ganglia
目的 探讨Toth水解剖技术在经侧裂入路高血压脑出血显微手术中的可行性及应用价值. 方法 将新余市人民医院神经外科自2009年1月至2012年1月收治的48例高血压基底节区脑出血患者按随机数字表法分为2组,其中观察组在经侧裂入路显微外科手术中应用Toth水解剖技术,对照组采用传统的经侧裂入路显微外科手术治疗,每组各24例.术后随访3月,比较分析2组患者的手术时间、术后昏迷时间、血肿清除率、术后再出血率及日常生活能力评分(ADL). 结果 观察组患者的手术时间、术后昏迷时间、血肿清除率均明显优于对照组,差异有统计学意义(P＜0.05).患者术后3月内均完成随访,ADL分级在观察组和对照组中分布比较差异有统计学意义(Z=-1.998,P=0.046),观察组平均秩次(20.67)明显小于对照组(28.33),表明观察组预后明显优于对照组.观察组无一例死亡病例发生,对照组预后不良患者中有2例死亡. 结论 Toth水解剖技术用于高血压脑出血患者的治疗效果确切、创伤小,比传统经侧裂入路显微手术耗时少,对额颞叶的保护作用明确.
目的 探討Toth水解剖技術在經側裂入路高血壓腦齣血顯微手術中的可行性及應用價值. 方法 將新餘市人民醫院神經外科自2009年1月至2012年1月收治的48例高血壓基底節區腦齣血患者按隨機數字錶法分為2組,其中觀察組在經側裂入路顯微外科手術中應用Toth水解剖技術,對照組採用傳統的經側裂入路顯微外科手術治療,每組各24例.術後隨訪3月,比較分析2組患者的手術時間、術後昏迷時間、血腫清除率、術後再齣血率及日常生活能力評分(ADL). 結果 觀察組患者的手術時間、術後昏迷時間、血腫清除率均明顯優于對照組,差異有統計學意義(P＜0.05).患者術後3月內均完成隨訪,ADL分級在觀察組和對照組中分佈比較差異有統計學意義(Z=-1.998,P=0.046),觀察組平均秩次(20.67)明顯小于對照組(28.33),錶明觀察組預後明顯優于對照組.觀察組無一例死亡病例髮生,對照組預後不良患者中有2例死亡. 結論 Toth水解剖技術用于高血壓腦齣血患者的治療效果確切、創傷小,比傳統經側裂入路顯微手術耗時少,對額顳葉的保護作用明確.
목적 탐토Toth수해부기술재경측렬입로고혈압뇌출혈현미수술중적가행성급응용개치. 방법 장신여시인민의원신경외과자2009년1월지2012년1월수치적48례고혈압기저절구뇌출혈환자안수궤수자표법분위2조,기중관찰조재경측렬입로현미외과수술중응용Toth수해부기술,대조조채용전통적경측렬입로현미외과수술치료,매조각24례.술후수방3월,비교분석2조환자적수술시간、술후혼미시간、혈종청제솔、술후재출혈솔급일상생활능력평분(ADL). 결과 관찰조환자적수술시간、술후혼미시간、혈종청제솔균명현우우대조조,차이유통계학의의(P＜0.05).환자술후3월내균완성수방,ADL분급재관찰조화대조조중분포비교차이유통계학의의(Z=-1.998,P=0.046),관찰조평균질차(20.67)명현소우대조조(28.33),표명관찰조예후명현우우대조조.관찰조무일례사망병례발생,대조조예후불량환자중유2례사망. 결론 Toth수해부기술용우고혈압뇌출혈환자적치료효과학절、창상소,비전통경측렬입로현미수술모시소,대액섭협적보호작용명학.
Objective To investigate the feasibility of microsurgery therapy with Toth water dissection technique for patients with hypertensive intracerebral hemorrhage via lateral fissure approach.Methods Forty-eight patients with hypertension basal ganglia cerebral hemorrhage,admitted to our hospital from January 2009 to January 2012,were selected in our study; they were divided into two groups according to different treatment methods:the observation group (n=24) chose Toth water dissection technique via lateral fissure approach and the control group (n=24) adopted surgery via lateral fissure approach.The operation time,postoperative coma time,hematoma clear rate,postoperative bleeding and activity of daily living (ADL) were compared between the two groups.Results Better results of operating time,postoperative coma time and hematoma clear rate in the observation group were noted as compared with those in the control group with significant differences (P＜0.05).All patients were followed up for 3 months; significant difference on ADL grading was noted between the observation group and the control group (Z=-1.998,P=0.046).The mean rank in the observation group (20.67) was obviously smaller than that in the control group (28.33),indicating that the prognosis in the observation group was better than that in the control group.No death was noted in the observation group while two in the control group.Conclusion Toth water dissection technique has better effect,enjoying smaller trauma,simpler operation,less time consuming and better protective effects on frontal and temporal lobes,in patients with hypertensive intracerebral hemorrhage as compared with traditional lateral fissure technology.
