Comparison of Effect of Microscopic Surgery via Different Approaches in Treatment of Young Patients with Severe Hypertensivebasal Ganglia Hemorrhage

Kun WANG; Jun PU; Tao YANG; Lu WANG; Dongbo LI

doi:10.12259/j.issn.2095-610X.S20240708

Volume 45 Issue 7

Jul. 2024

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2024 > 45(7): 56-61

Kun WANG, Jun PU, Tao YANG, Lu WANG, Dongbo LI. Comparison of Effect of Microscopic Surgery via Different Approaches in Treatment of Young Patients with Severe Hypertensivebasal Ganglia Hemorrhage[J]. Journal of Kunming Medical University, 2024, 45(7): 56-61. doi: 10.12259/j.issn.2095-610X.S20240708

Citation:

Kun WANG, Jun PU, Tao YANG, Lu WANG, Dongbo LI. Comparison of Effect of Microscopic Surgery via Different Approaches in Treatment of Young Patients with Severe Hypertensivebasal Ganglia Hemorrhage[J]. Journal of Kunming Medical University, 2024, 45(7): 56-61. doi: 10.12259/j.issn.2095-610X.S20240708

Citation:

Kun WANG, Jun PU, Tao YANG, Lu WANG, Dongbo LI. Comparison of Effect of Microscopic Surgery via Different Approaches in Treatment of Young Patients with Severe Hypertensivebasal Ganglia Hemorrhage[J]. Journal of Kunming Medical University, 2024, 45(7): 56-61. doi: 10.12259/j.issn.2095-610X.S20240708

PDF( 593 KB)

Comparison of Effect of Microscopic Surgery via Different Approaches in Treatment of Young Patients with Severe Hypertensivebasal Ganglia Hemorrhage

doi: 10.12259/j.issn.2095-610X.S20240708

Kun WANG¹,
Jun PU²,
Tao YANG¹,
Lu WANG¹,
Dongbo LI^{1
,
,}

1.
Dept. of Neurosurgery，Ankang Central Hospital ，Ankang Shaanxi 72500
2.
Dept. of Neurosurgery，The 2nd Affiliatted Hospital of Kunming Medical University，Kunming Yunnan 650101，China

Received Date: 2024-03-15
Available Online: 2024-06-15
Publish Date: 2024-07-25

Abstract

Abstract

Objective To compare the effect of different approaches of microscopic surgery in the treatment of severe hypertensivebasal ganglia hemorrhage （HBGH） in young patients. Methods A retrospective analysis was performed on young patients with severe HBGH admitted to the department of Neurosurgery of Ankang Central Hospital from July 2017 to June 2023. According to the different surgical approaches, the patients were divided into a lateral fissure group （microscopic hematoma removal via lateral fissure approach） and a middle temporal gyrus group （microscopic hematoma removal via middle temporal gyrus approach）. According to the propensity matching score method （caliper=0.02）, the confounding factors were excluded, and 40 patients were obtained in each group. The hematoma clearance rate, perioperative indicators （surgical time, intraoperative blood loss, hospital stay, re-hemorrhage rate）, incidence rates of complications, preoperative and postoperative serum indicators at 3 months [neuron specific enolase （NSE）, S-100 protein], prognosis status （GOS）at 3 months after surgery and symptom improvement [modified Rankin scale （mRS）, activity of daily living （ADL）] at 3 and 6 months after surgery were compared between the two groups. Results Within 24 hours after surgery, the hematoma clearance rate in lateral fissure group was significantly better than that in the middle temporal gyrus group （P < 0.05）. There were no significant differences in the surgical time and re-hemorrhage rate between both groups （P > 0.05）, but the intraoperative blood loss and hospital stay in the lateral fissure group were significantly less or shorter than those in the middle temporal gyrus group （P < 0.05）. There was no statistically significant difference in the incidence of complications between the two groups （P > 0.05）. At 3 months after surgery, NSE and S100 in both groups of patients significantly decreased （P < 0.05）, and the lateral fissure group was significantly lower than the middle temporal gyrus group （P < 0.05）. After 3 months of surgery, the GOS grading of the lateral fissure group was significantly better than that of the middle temporal gyrus group （P < 0.05）. At 3 and 6 months after surgery, the mRS in the two groups decreased gradually （P < 0.05） while the ADL increased gradually （P < 0.05）. The mRS in the lateral fissure group was significantly lower （P < 0.05） while the ADL was significantly higher than that in the middle temporal gyrus group （P < 0.05）. Conclusion Compared with the middle temporal gyrus approach, the lateral fissure approach in the treatment of severe HBGH has a higher hematoma removal rate, shorter surgical time, less blood loss and better prognosis of patients.
- Severe hypertensive basal ganglia hemorrhage,
- Hematoma removal,
- Craniotomy

FullText(HTML)

References(18)

References

[1]	Robles L A,Volovici V. Hypertensive primary intraventricular hemorrhage: A systematic review[J]. Neurosurg Rev,2022,45(3):2013-2026. doi: 10.1007/s10143-022-01758-8
[2]	Ikeda S,Tsutsumi M,Fujita M,et al. Intracranial myeloid sarcoma mimicking hypertensive intracerebral hemorrhage[J]. Intern Med,2023,62(17):2539-2545. doi: 10.2169/internalmedicine.9774-22
[3]	Boissonneau S,Graillon T,Rolland A,et al. Management of patients suffering from hemorrhagic intracranial metastases: Propositions to help the neurosurgeon in emergency situations based on a literature review[J]. Neurochirurgie,2021,67(4):369-374. doi: 10.1016/j.neuchi.2020.11.005
[4]	党连锋,杨春. 术前栓塞联合经对侧纵裂入路术治疗巨大镰窦旁脑膜瘤疗效研究[J]. 陕西医学杂志,2022,51(8):982-985,1020.
[5]	王运华,耿凤阳,付强. 高血压性脑出血的外科治疗[M]. 北京: 军事医学科学出版社,2006: 33.
[6]	Haggag H,Hodgson C. Clinimetrics: Modified rankin scale (mRS)[J]. J Physiother,2022,68(4):281. doi: 10.1016/j.jphys.2022.05.017
[7]	Messina S,Frongia A L,Antonaci L,et al. A critical review of patient and parent caregiver oriented tools to assess health-related quality of life,activity of daily living and caregiver burden in spinal muscular atrophy[J]. Neuromuscul Disord,2019,29(12):940-950. doi: 10.1016/j.nmd.2019.10.001
[8]	Puzzi V C,Oliveira J M,Alves T B,et al. Reliability and validity of the London Chest Activity of Daily Living scale for adults with asthma[J]. J Asthma,2024,61(1):1-9. doi: 10.1080/02770903.2023.2234990
[9]	Haseler E,Sinha M D. Hypertension in children and young adults[J]. Pediatr Clin North Am,2022,69(6):1165-1180. doi: 10.1016/j.pcl.2022.07.005
[10]	张秀斌,李佩军. 经侧裂-岛叶入路显微手术治疗基底节区高血压脑出血疗效分析[J]. 中西医结合心脑血管病杂志,2021,19(6):1054-1056.
[11]	兰荣宝. 颅内压监测下控制性减压在重型颅脑损伤患者开颅血肿清除术中的应用价值[J]. 中国医师杂志,2023,25(4):610-614.
[12]	崔江丽,关慧慧,王许强,等. 基于DTI评估内镜经额入路与经颞入路手术治疗基底节脑出血的预后研究[J]. 临床神经外科杂志,2023,20(1):15-19.
[13]	Sun H,Wang Y,Wang L,et al. Endoscopic-assisted trans-lateral ventricular transchoroidal fissure trans-aqueductal approach for evacuation of severe intraventricular hemorrhage[J]. World Neurosurg,2022,167(1):1317-1324.
[14]	郑鹏锋,曾广明,陈昱. 神经内镜锁孔开颅清除急性外伤性硬膜下血肿的疗效分析[J]. 中华神经外科杂志,2023,39(11):1110-1114.
[15]	裴献光,高芳,许亚宁,等. 神经内镜微侵袭手术在高血压脑出血中的临床疗效及预后[J]. 中国临床研究,2023,36(8):1157-1161.
[16]	Nyquist P. Editorial for "Significance of Cerebral Small-Vessel Disease on Perihematomal Edema Progress in Patients With Hypertensive Intracerebral Hemorrhage"[J]. J Magn Reson Imaging,2023,57(1):225-226. doi: 10.1002/jmri.28238
[17]	周向阳,丁正斌,董昕,等. 穿刺引流术与小骨窗开颅血肿清除术治疗高血压脑出血的临床疗效对比[J]. 中国医师杂志,2023,25(2):263-265.
[18]	惠磊,李祥生,岳双柱,等. 不同手术方式对基底核区脑出血患者的疗效差异及免疫功能的影响[J]. 中华老年心脑血管病杂志,2022,24(4):404-407.

Relative Articles(20)

Relative Articles

[1]	Guangping ZHAO, Panpan LIU, Fei LIU, Wei LI, Yongxue CHEN, Kai ZHANG. Observations on Hemodynamics and Stress Response of the Different Anesthesia Methods in Stereotactic Intracranial Hematoma Removal for Hypertensive Intracerebral Hemorrhage. Journal of Kunming Medical University, 2022, 43(5): 117-122. doi: 10.12259/j.issn.2095-610X.S20220521
[2]	Qi Jun Hui , Luo Lin , Yu Ze Ran , Shi Zhen Jiang , Zhuang Yong Hui , Dai Cheng Guo . . Journal of Kunming Medical University, 2020, 41(02): 54-58.
[3]	Chen Xu , Wang Fei , Zhang Chun Qiang , Guo Pei Yu , Wang Yi Zhou , Du Kai Li . . Journal of Kunming Medical University, 2020, 41(06): 72-76.
[4]	Lu Qiu An , Du Kai Li , Zhang Chun Qiang , Guo Pei Yu , Sun Yu Peng , He Shao Bo . . Journal of Kunming Medical University, 2017, 38(05): 83-86.
[5]	Li Ming . Surgical Management of Sylvian Lateral Fissure Approach in the Treatment of Patients with Hypertensive Intracerebral Hemorrhage on Basal Ganglia. Journal of Kunming Medical University,
[6]	Zhang Wen Xia . . Journal of Kunming Medical University,
[7]	Liu Le Wan . . Journal of Kunming Medical University,
[8]	Yang Juan . . Journal of Kunming Medical University,
[9]	Liu Le Wan . . Journal of Kunming Medical University,
[10]	Yan Qi . . Journal of Kunming Medical University,
[11]	Luo Xuan Rong . . Journal of Kunming Medical University,
[12]	Liu Ze Fei . . Journal of Kunming Medical University,
[13]	Dong Jian Ping . . Journal of Kunming Medical University,
[14]	Zhang Ming . . Journal of Kunming Medical University,
[15]	Gao Li Ping . . Journal of Kunming Medical University,
[16]	Liu Ze Fei . . Journal of Kunming Medical University,
[17]	. . Journal of Kunming Medical University,
[18]	. . Journal of Kunming Medical University,
[19]	Niu Hua Tao . . Journal of Kunming Medical University,
[20]	Zhuang Yong Hui . . Journal of Kunming Medical University,