目的 研究高血压脑出血行经外侧裂-岛叶入路显微手术治疗对患者昏迷时间、神经功能及预后的影响.方法 取2014年2月至2016年5月本院与协助单位广东三九脑科医院诊治为高血压脑出血92例患者临床资料予以分析,按照临床选择的不同手术治疗方案分成2组,对照组行传统骨瓣开颅术医治,观察组行经外侧裂-岛叶入路显微术医治,分析比较2种手术方式对患者昏迷时间、神经功能及预后的影响.结果 观察组手术时间、术后昏迷时间均比对照组短,术后12h残余血肿量(5.2±1.0)mL比对照组(9.9±3.5)mL少,差异有统计学意义(P ＜0.01);观察组术后3个月神经功能和日常生活能力评分均比对照组高(P＜0.01),且总并发症率9％比对照组28％低,2组上述各指标比较差异有统计学意义(P＜0.05).结论 高血压脑出血行经外侧裂-岛叶入路显微手术治疗可缩短患者昏迷时间和改善其神经功能,且预后良好.%Objective To study the effects of microsurgical treatment of the lateral fissure-insular approach on coma time,neurological function and prognosis of patients with hypertensive intracerebral hemorrhage.Methods From February 2014 to May 2016,the clinical data of 92 patients with hypertensive intracerebral hemorrhage diagnosed and treated in our hospital were analyzed and divided into two groups according to the different surgical treatment options.The patients in the observation group were treated by lateral fissure-insular lobular microsurgery,and the effects of the two surgical methods on coma time,neurological function and prognosis were analyzed.Results The operation time and coma time of the observation group were shorter than those of the control group.The residual hematoma volume (5.2 ± 1.0) mL was less than that of the control group (9.9±3.5)mL at 12h after operation,the difference was statistically significant (P ＜0.01),and the total complication rate was 9％ lower than that in the control group (28％).Compared with the control group,the neurological function and daily living ability scores of the observation group were significantly lower than those of the control group The difference was statistically significant (P ＜0.05).Conclusion Microsurgical treatment of hypertensive intracerebral hemorrhage via lateral fissure-insular approach could shorten coma time and improve neurological function,and the prognosis was good.
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