The Effect of Language Function Recovery by Hematoma Clearance via Different Surgical Approaches for the Patients with Basal Ganglia Intracerebral Hemorrhage in Dominant Side
SUN Xi-feng,TANG Yong,FAN Yong-zhong
Department of Neurosurgery,Danyang People's Hospital of Jiangsu Province,Danyang212300,Jiangsu,China
摘要 目的探讨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。方法选取2014年1月～2017年1月我科收治的优势侧基底节区出血患者80例，随机分为两组，各40例：观察组采用侧裂-岛叶入路，对照组采用颞中回入路行小骨窗开颅血肿清除术。比较两组患者血肿清除效果、语言功能恢复情况以及预后。术后1个月及3个月采用汉语失语症成套检测(ABC)评价患者语言功能情况，术后3个月采用波士顿诊断性失语症检查量表(BDAE)评价患者失语症严重程度与恢复情况，预后采用格拉斯哥预后评分进行评估。结果观察组血肿清除率优于对照组(92.50% VS 75.00%，P<0.05)， 预后良好率高于对照组 (77.50% VS 55.00%，P<0.05)。汉语失语症成套检测结果显示两组患者术后3月均较术后1月有明显改善 (P<0.05)， 组间比较观察组术后3月改善效果优于对照组 (P<0.05)。术后3月观察组语言功能恢复良好率明显高于对照组(82.50% VS 62.50%，P<0.05)。结论经侧裂-岛叶入路行血肿清除治疗优势侧基底节区脑出血，可显著提高手术效果，改善患者预后，促进患者语言功能恢复。
Abstract: ObjectiveTo investigate the effect of linguistic function recovery treated by surgical intervention of hematoma clearance via transsylvian-insular approach and tansmidtemporal gyrus approach for basal ganglia cerebral hemorrhage in dominant side.MethodsA total of 80 patients with basal ganglia hematoma in dominant side admitted from January 2014 to January 2017 were enrolled the research. They were divided into two groups by random number table method, with 40 cases in each group. The observation group was performed hematoma clearance via transsylvian-insular approach and the control group via tansmidtemporal gyrus approach. The hematoma clearance results, the recovery of language function and the prognosis was compared between two groups. The Aphasia Battery of Chinese (ABC) was applied to evaluate the language function recovery 1- and 3 months after surgery, the Boston diagnostic aphasia examination(BDAE) was to assess the aphasia 3 months after the surgery, and Glasgow Outcome Scale (GOS) was to indicate the prognosis.ResultsThe hematoma clearance rate and eusemia rate was 92.50% and 77.50% respectively in the observation group, which was significantly higher than 75.00% and 55.00% respectively in the control group, and there were statistical differences between two groups (P<0.05). The ABC results of language function was improved 3 months after the surgery than 1 month after the surgery in both two groups(P<0.05), while the recovery effect of the observation group was more superior than that of the control group 3 months after the surgery (P<0.05). The BDAE results showed that the fineness recovery rate of the observation group was remarkable higher than that of the control group (82.50% VS 62.50%,P<0.05).ConclusionThe surgical intervention of hematoma clearance is effective for the patients with dominant lateral cerebral basal ganglia hemorrhage via transsylvian-insular approach, and it can increase the effect of the operation, improve the prognosis and promote the recovery of the language function.
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.
SUN Xi-feng. The Effect of Language Function Recovery by Hematoma Clearance via Different Surgical Approaches for the Patients with Basal Ganglia Intracerebral Hemorrhage in Dominant Side. Chinese Journal of Modern Operative Surgery, 2017, 21(6): 468-472.
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2017, Vol. 21 
