Contrast of lateral fissure and temporal approach hematoma evacuation for protecting the cerebral vascular in patients with basal ganglion hemorrhage

doi:10.3877/cma.j.issn.2095-9141.2019.04.007

Abstract

Abstract:

Objective

To discuss the contrast of lateral fissure and temporal approach hematoma evacuation for protecting the cerebral vascular in patients with basal ganglion hemorrhage.

Methods

Sixty patients with basal ganglion hemorrhage admitted to the Neurosurgery Department of the Fangchenggang First People’s Hospital from January 2010 to December 2016 were selected. According to the approach, the patients were divided into lateral and temporal groups, 30 cases in each group. The lateral group was treated with hematoma clearance through lateral fissure approach, and the temporal group was treated with hematoma clearance through temporal approach. Hematoma clearance rate, endothelial function, complications, operation and prognosis were compared between the two groups.

Results

The hematoma clearance rate and GOS score of lateral group were significantly higher than those of temporal group, and the complication rate was significantly lower than that of temporal group (P<0.05), but the operation time and intraoperative bleeding volume of two groups were basically the same, with no significant difference (P>0.05); the level of serum endothelin (ET) in 2 groups was significantly lower than that before operation. However, the level of serum ET in the lateral approach group was significantly lower than that in the temporal approach group (P<0.05).

Conclusion

Hematoma removal through lateral fissure approach can effectively improve endothelial function and reduce complications in patients with basal ganglia hemorrhage. It is conducive to protecting cerebrovascular and improving short-term and long-term efficacy. It is worthy of further clinical promotion.

Key words: Lateral fissure approach, Temporal approach, Hematoma evacuation, Basal ganglion hemorrhage, Cerebral vascular

Rushen Li, Naijian Xie, Haonan Shen, Gonghuang Chen. Contrast of lateral fissure and temporal approach hematoma evacuation for protecting the cerebral vascular in patients with basal ganglion hemorrhage[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2019, 05(04): 218-222.

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References 20

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组别	例数	血肿清除率（%）	手术时间（min）	术中出血量（mL）
颞路组	30	83.45±7.51	97.48±12.54	36.97±5.02
侧路组	30	90.47±7.84	96.84±12.03	36.04±4.95
t值	?	3.542	0.202	0.723
P值	?	<0.001	0.851	0.342

组别	例数	血肿清除率（%）	手术时间（min）	术中出血量（mL）
颞路组	30	83.45±7.51	97.48±12.54	36.97±5.02
侧路组	30	90.47±7.84	96.84±12.03	36.04±4.95
t值	?	3.542	0.202	0.723
P值	?	<0.001	0.851	0.342

组别	例数	肺部感染	再出血	脑梗死	精神障碍	发生率（%）
颞路组	30	2（6.67）	3（10.00）	3（10.00）	3（10.00）	36.67
侧路组	30	2（6.67）	1（3.33）	0（0.00）	1（3.33）	13.33
χ²值	?	?	?	?	?	4.356
P值	?	?	?	?	?	0.046

组别	例数	肺部感染	再出血	脑梗死	精神障碍	发生率（%）
颞路组	30	2（6.67）	3（10.00）	3（10.00）	3（10.00）	36.67
侧路组	30	2（6.67）	1（3.33）	0（0.00）	1（3.33）	13.33
χ²值	?	?	?	?	?	4.356
P值	?	?	?	?	?	0.046

组别	例数	术前	术后1 d	术后4 d	术后7 d	F值	P值
颞路组	30	106.48±11.32	92.46±10.42	81.72±8.61	66.47±7.52	27.472	<0.001
侧路组	30	107.54±11.63	83.14±8.86	72.47±7.67	47.31±5.29	36.124	<0.001
t值	?	0.358	3.732	4.394	11.414	?	?
P值	?	0.722	<0.001	<0.001	<0.001	?	?

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