Objective:To investigate the clinical efficacy of small skull-window microsurgery through lateral fissure-insula lobe approach for cerebral hemorrhage in basal ganglia and its influence on inflammation-oxidative stress. Methods:Ninety-six cases of patients with basal ganglia cerebral hemorrhage undergoing small skull-window microsurgery were randomly divided into two groups:the lateral fissure-insula lobe approach group (group A, n=48) and temporal lobe cortex approach group (group B, n=48). The perioperative conditions and clinical outcome were compared between the two groups.The serum levels of inflammatory markers[interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), high mobility group protein-1 (HMGB-1)] and oxidative stress indicators[superoxide dismutase (SOD), malondialdehyde (MDA)] were measured before surgery and on the 1st,3rd,7th day after surgery. Results:There were no significant differences in intraoperative bleeding, operation time, postoperative recovery time and incidence of complications between the two groups (P>0.05). The hematoma clearance rate ≥ 95% was 87.50% in group A, significantly higher than 70.83% in group B (P<0.05). On the 1st, 3rd and 7th day after surgery,the serum levels of IL-6, TNF-α, CRP, HMGB-1 and MDA in group A were significantly lower than those in the group B, while SOD levels were significantly higher (P<0.05); At 6 months after surgery, the good rate of prognosis was 55.56% in group A, significantly higher than 32.56% in group B (P<0.05). Conclusion:Compared with temporal lobe cortex approach,the small skull-window microsurgery through lateral fissure-insula lobe approach for the treatment of basal ganglia cerebral hemorrhage has the advantages of less trauma and less inflammatory-oxidative stress, and the short-term prognosis is good. |
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