经脑沟裂手术与传统手术治疗优势半球高血压基底节脑出血患者术后语言功能恢复的对比研究

doi:10.3760/cma.j.cn101202-20191016-00312

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摘要目的探讨经脑沟裂手术与传统经皮层造瘘手术治疗优势半球高血压基底节脑出血患者术后语言功能的恢复情况。方法回顾性分析2016年1月—2018年12月阜阳市人民医院收治的58例优势半球高血压基底节脑出血手术患者的临床资料,其中男33例、女25例,年龄36～79(58.0±8.7)岁。58例患者根据手术入路不同分为两组,采用脑沟裂入路手术者30例纳入脑沟裂组,采用颞叶皮层造瘘入路手术28例纳入对照组。分别于术后1、3个月采用西部失语症成套检查标准评价患者的失语情况,计算失语指数(AQ),根据AQ对比两组患者语言功能的恢复情况。结果脑沟裂组和对照组患者术后1个月的AQ分别为(42.77±6.98)分和(30.98±6.21)分,术后3个月的AQ分别为(47.12±8.85)分和(62.45±9.30)分。脑沟裂组患者术后1、3个月的AQ均高于对照组,差异均有统计学意义(t=6.770、6.421, P值均<0.01)。组内比较,两组患者术后3个月AQ均明显高于术后1个月,差异均有统计学意义(t=16.936、15.043,P值均<0.01)。结论对于优势半球基底节中等量(30～60 mL)脑出血的患者,优先选择经脑沟裂入路手术清除血肿,有助于改善患者术后语言功能。

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	高志波
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关键词 ：颅内出血,高血压性, 优势半球, 基底节区, 失语

Abstract：Objective This work aims to investigate the effect of different surgical methods on language function recovery in patients with superior hemispheric hypertension with basal ganglia intracerebral hemorrhage.Methods Retrospective analysis was conducted on the clinical data of 58 patients suffering from superior hemispheric hypertension with basal ganglia intracerebral hemorrhage and treated in Fuyang people's Hospital from January 2016 to December 2018. The patients consisted of 33 males and 25 females aged 36-79 (58.0±8.7) years and were categorized into two groups according to the operation: 30 were treated by the sulcus approach, and 28 were treated by the temporal cortical fistula approach. Aphasia was evaluated through western aphasia examination standard 1 at 3 months post-operation. Aphasia index (AQ) was calculated and used as the basis for the comparison of language function recovery in the two groups.Results The AQ of the observation and control groups were (42.77±6.98) and (30.98±6.21), respectively, and the AQ at 3 months post-operation were (47.12±8.85) and (62.45±9.30), respectively. The AQ of the observation group was higher than that of the control group at 1 and 3 months post-operation, and the difference was statistically significant (t=6.770, 6.421, all P values<0.01). The AQ at 3 months post-operation was significantly higher than that at 1 month post-operation in both groups (t=16.936, 15.043, all P values<0.01).Conclusions For patients with moderate cerebral hemorrhage (30-60 mL) in the basal ganglia of the dominant hemisphere, the sulcus approach is the primary treatment to clear the hematoma and help improve the language function recovery after operation.

Key words： Intracranial hemorrhage, hypertensive Dominant hemisphere Basal ganglia Aphasia

收稿日期: 2019-10-16

通讯作者: 高志波,Email: gzb688@126.com

引用本文:

高志波, 孙鹏举, 李琦, 陈洪山, 朱司阳, 田野, 陈彬. 经脑沟裂手术与传统手术治疗优势半球高血压基底节脑出血患者术后语言功能恢复的对比研究[J]. 中华解剖与临床杂志, 2020, 25(4): 406-410.
Gao Zhibo, Sun Pengju, Li Qi, Chen Hongshan, Zhu Siyang, Tian Ye, Chen Bin. Language function recovery after the treatment of sulcus fissure and traditional surgery for superior hemispheric hypertension with basal ganglia intracerebral hemorrhage. Chinese Journal of Anatomy and Clinics, 2020, 25(4): 406-410.

链接本文:

http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20191016-00312 或 http://www.cjac.com.cn/CN/Y2020/V25/I4/406

[1]	Zuo S, Pan P, Li Q, et al. White matter injury and recovery after hypertensive intracerebral hemorrhage[J]. Biomed Res Int, 2017, 2017: 6138424. DOI:10.1155/2017/6138424.
[2]	Suzuki K, Matsuoka G, Abe K, et al. Subpial hematoma and extravasation in the interhemispheric fissure with subarachnoid hemorrhage[J]. Neuroradiol J, 2015, 28(3): 337-340. DOI:10.1177/1971400915576664.
[3]	孙夕峰, 唐勇, 樊永忠. 不同手术入路对优势侧基底节区脑出血患者语言功能恢复的影响[J]. 中国现代手术学杂志, 2017, 21(6): 468-472. DOI:10.16260/j.cnki.1009-2188.2017.06.017. Sun XF, Tang Y, Fan YZ. The effect of language function recovery by hematoma clearance via different surgical approaches for the patients witli basal ganglia intracerebral hemorrhage in dominant side[J]. Chinese Journal of Modern Operative Surgery, 2017, 21(6): 468-472. DOI:10.16260/j.cnki.1009-2188.2017.06.017.
[4]	高志波, 钱令涛, 陈彬, 等. 经脑沟裂入路治疗高血压基底核脑出血[J]. 中华解剖与临床杂志, 2014, 19(2): 121-125. DOI:10.3760/cma.j.issn.2095-7041.2014.02.009.Gao ZB, Qian LT, Chen B, et al. Treatment of intracerebral hematomas in basal ganglia region via transsylvian fissure or cortical sulci-insular approach[J]. Chin J Anat Clin, 2014, 19(2): 121-125. DOI:10.3760/cma.j.issn.2095-7041.2014.02.009.
[5]	王荫华. 西方失语症成套测验(WAB)介绍(一)[J]. 中国康复理论与实践, 1997, 3(2): 87-89.
[6]	Sebastian R, Schein MG, Davis C, et al. Aphasia or neglect after thalamic stroke: the various ways they may be related to cortical hypoperfusion[J]. Front Neurol, 2014, 5: 231. DOI:10.3389/fneur.2014.00231.
[7]	陈建超, 苏国新, 刘秀兰, 等. 经翼点外侧裂人路行高血压性基底节区脑出血血肿清除术[J]. 中国煤炭工业医学杂志, 2004, 7(6): 515-516. DOI:10.3969/j.issn.1007-9564.2004.06.023.
[8]	陈沛林, 王伟金, 叶波林, 等. 经颞叶入路与经中央脑沟皮质入路手术治疗基底节出血的对照研究[J]. 江西医药, 2016, 51(11): 1193-1195. DOI:10.3969/j.issn.1006-2238.2016.11.021.
[9]	Gao Z, Qian L, Niu C, et al. Evacuating hypertensive intracerebral hematoma with a cortical sulcus approach[J]. World Neurosurg, 2016, 95: 341-347. DOI:10.1016/j.wneu.2016.08.030.
[10]	Qu Y, Ren B, Chang X, et al. Morphologic study of superior temporal sulcus-amygdaloid body and lateral fissure-amygdaloid body surgical approach by using magnetic resonance imaging volume rendering[J]. J Craniofac Surg, 2016, 27(1): 177-180. DOI:10.1097/SCS.0000000000002340.
[11]	黄永凯, 包正军, 韩德清, 等. 优势侧基底节区脑出血手术入路的选择[J]. 中国现代医学杂志, 2017, 27(5): 59-62. DOI:10.3969/j.issn.1005-8982.2017.05.012.Huang YK, Bao ZJ, Han DQ, et al. Approach to evacuate basalganglia hem atom a in dominant side[J]. China Journa of Modern Medcine, 2017, 27(5): 59-62. DOI:10.3969/j.issn.1005-8982.2017.05.012.
[12]	Ye Z, Ai X, Hu X, et al. Comparison of neuroendoscopic surgery and craniotomy for supratentorial hypertensive intracerebral hemorrhage: a meta-analysis[J]. Medicine (Baltimore), 2017, 96(35): e7876. DOI:10.1097/MD.0000000000007876.