标题：小骨窗侧裂入路显微手术治疗高血压性基底节区出血的临床研究

      作者：李从进 1，李东波 1，刘锋 1，王松林 1，师弘 2    (1.安康市中心医院神经外科，陕西 安康 725000；2.空军军医大学(第四军医大学)唐都医院肿瘤科，陕西 西安 700038)

      卷次： 2018年29卷24期

      【摘要】 目的 探讨小骨窗侧裂入路显微手术治疗高血压性基底节区出血的临床疗效。方法 回顾性分析2013年5月至2018年5月安康市中心医院神经外科收治的高血压性基底节出血患者117例的临床资料，按照手术方式不同分为观察组(59例)与对照组(58例)，观察组给予小骨窗侧裂入路显微手术治疗，对照组给予传统大骨瓣开颅手术治疗，比较两组患者的治疗效果、复发率、死亡率、功能恢复情况及并发症情况。结果 观察组患者术后功能恢复情况明显优于对照组，差异均具有统计学意义(P<0.05)；观察组患者的治疗有效率为93.2%，明显高于对照组的51.7%，差异具有统计学意义(P<0.05)；观察组患者术后死亡率为5.1%，明显低于对照组的20.7%，术后复发率为5.1%，明显低于对照组的37.9%，差异均具有统计学意义(P<0.05)；两组患者术后的主要并发症为肺部感染、消化道出血、泌尿系感染、腹泻等，观察组并发症发生率为 5.1%，明显低于对照组的 24.1%，差异具有统计学意义(P<0.05)。结论 小骨窗侧裂入路显微手术治疗高血压性基底节区出血具有疗效高、患者术后恢复快、手术创伤小、术后并发症少等优点。
      【关键词】 小骨窗；侧裂入路；显微手术；大骨瓣开颅手术；高血压性脑出血；疗效
      【中图分类号】 R743.34 【文献标识码】 A 【文章编号】 1003—6350（2018）24—3460—03

Clinical study of microsurgical treatment of hypertensive basal ganglia hemorrhage with small bone windowlateral fissure approach.
LI Cong-jin 1, LI Dong-bo 1, LIU Feng 1, WANG Song-lin 1, SHI Hong 2. 1. Department ofNeurosurgery, Ankang Central Hospital, Ankang 725000, Shaanxi, CHINA; 2. Department of Oncology, Tangdu Hospital,the Fourth Military Medical University, Xi'an 700038, Shaanxi, CHINA
【Abstract】 Objective To discuss the clinical effect of microsurgical treatment of hypertensive basal ganglia in-tracranial hemorrhage with small bone window lateral fissure approach. Methods Clinical data were retrospectively an-alyzed on 117 patients with hypertensive basal ganglia intracranial hemorrhage admitted to the Department of Neurosur-gery at the Ankang Central Hospital during May 2013 and May 2018. The patients were divided into an observationgroup (n=59) and a control group (n=58) according to different operation methods. The observation group was treatedwith microsurgical treatment through small bone window lateral fissure approach, and the control group was treated withtraditional large craniotomy. The treatment effect, recurrence rate, mortality rate, functional recovery and complicationswere compared between the two groups. Results The postoperative functional recovery of the observation group wassignificantly better than that of the control group, and the difference was statistically significant (P<0.05). The effectiverate of treatment in the observation group was 93.2%, which was significantly higher than 51.7% in the control group (P<0.05). In the observation group, the postoperative mortality rate was 5.1%, which was significantly lower than 20.7% inthe control group; the recurrence rate was 5.1%, which was significantly lower than 37.9% in the control group; the dif-ferences were statistically significant (P<0.05). The main complications of the two groups were pulmonary infection, gas-trointestinal hemorrhage, urinary tract infection and diarrhea. The incidence of complications in the observation groupwas 5.1%, which was significantly lower than 24.1% in the control group, and the difference was statistically significant(P<0.05). Conclusion Microsurgical treatment of hypertensive intracranial hemorrhage through small bone window lat-eral fissure approach has the advantages of high curative effect, quick postoperative recovery, minimal surgical traumaand less postoperative complications.
      【Key words】 Small bone window; Lateral fissure approach; Microsurgery; Large craniotomy; Hypertensive intra-cranial hemorrhage; Clinical effect·论 著·doi:10.3969/j.issn.1003-6350.2018.24.018基金项目：陕西省科技厅计划项目(编号：QS061-C33-21)