Microsurgical operation through lateral fissure-insula lobe approach in treatment of hypertensive cerebral hemor- rhage in basal ag nglia

TANG Jianjian; ZHANG Ziyin; ZHOU Jian; MA Chunyang; WANG Zizhen; HUANG Qiuhu

doi:10.3969/j.issn.1671-6450.2014.10.003

Abstract：Objective To investigate the curative effect of the transsylvian insular approach , microsurgical operation on hypertensive cerebral hemorrhage in basal ganglion .Methods From 2010 January to 2013 June, a retrospective analysis the clinical data of 64 cases hypertensive cerebral hemorrhage were performed .Among them, 41 cases underwent lateral fis-sure and insula microsurgical operation ( group A ); the other 23 underwent conventional craniotomy operation ( group B ) , compare the therapeutic effect of 2 groups and the short -and long-term prognosis .Results The operation time of group A was (115.35 ±46.23) min, automatic opening eye time after operation was (5.22 ±3.43) h, which were all shorter than in the B group’s (212.43 ±58.24) min, and (8.74 ±4.51)h ( P <0.05).After 7 d, group A’s GCS score was (11.92 ± 2.73) points, which is higher than that in group B with (9.85 ±2.46) points ( P <0.05).After 48 h’s CT examination re-vealed that, group A’s most hematoma clearance rate was 80.49%(33/41), which is better than that of B group ’s 56.52%(13/23) ( P <0.05).The observation group had no significant difference with the control group in the incidence of compli -cations (39.02%vs.47.83%, P >0.05).Followed up after operation for 3 months, in group A, the excellent and good rate was 60.98%(25/41), significantly higher than that of group B ’s 34.78%(8/23) ( P <0.05).Followed up for 12 months after operation, in group A, the excellent and good rate was 72.50%(29/40), significantly higher than that of group B’s 47.62%(10/21) ( P <0.05).Conclusion Through lateral fissure and insula microsurgical operation for treatment of brain hemorrhage is less injury , good efficacy and less complications .