Clinical efficiacy and method analysis of operation approach in lateral fissure for patients with HICH in basal ganglia region / 重庆医学

ABSTRACT

Objective To analyze clinical efficacy of operation approach in lateral fissure for patients with hypertensive intracerebral hemorrhage (HICH) in basal ganglia region.Methods Retrospectively analyzed 120 cases of patients with HICH in basal ganglia region in the department of neurosurgery in our hospital from 2012 to 2015.Among them,64 cases of patients were treated by surgery via lateral fissure-insular approach (lateral fissure group),the other 56 cases of patients were treated by surgery via the traditional trans-temporal cortex approach (temporal lobe group).The perioperative indicators and clinical efficacy were compared between the two groups.Results Compared with the temporal lobe group,the operative time in the lateral fissure group was decreased,and the hematoma clearance rate was increased,there were statistically significant differences(P＜0.05).No statistically significant difference was found in postoperative re-bleeding rate and rate of complications between the two groups(P＞0.05).The activity of daily living (ADL) Barthel index scores,1 month,3 months and 6 months after operation,in the lateral fissure group were significantly higher than those in the temporal lobe group(P＜0.05).In the lateral fissure group one patient died and in the temporal lobe group 2 patients died.The proportion of patients with good prognosis in the lateral fissure group (70.31％) was higher than that in the the temporal lobe group(51.78％,P＜0.05).Conclusion Patients with HICH in basal ganglia region treated by operation via lateral fissure-insular approach undergo a shorter operation time,hematoma is evacuated more thoroughly,and have better postoperative prognosis,compared with those patients treated by operation via traditional trans-temporal cortex approach.