微创穿刺引流术与内科保守治疗基底核区中等量自发性脑出血的对照研究

Comparison of Minimally Invasive Puncture and Conservative Treatment on Middle-volume Intracerebral Hemorrhage in Basal Ganglia

目的:比较分析脑出血微创穿刺引流术与内科保守治疗两种方法治疗基底核区中等量自发性脑出血的临床疗效。方法:基底核区中等量自发性脑出血患者50例,按患者或家属意愿分为微创组31例和保守组19例,分别给予微创穿刺引流术和内科保守治疗。比较2组患者治疗1周后的Glasgow昏迷评分(GCS)和血肿体积变化、并发症发生率、死亡率、住院天数及3个月后日常生活能力(ADL)评分。结果:与保守组相比,微创组患者入院1周后GCS评分明显升高,血肿体积明显减少,住院天数明显缩短(P<0.05);再出血发生率、住院期间死亡率、3个月后ADL评分2组之间差异无统计学意义。结论:微创穿刺引流术能显著改善基底核中等量自发性脑出血患者的意识障碍,明显减小血肿体积。

Objective： To compare the clinical efficacy of conservative treatment and minimally invasive evacuation on patients with middle-volume intracerebral hemorrhage in the basal ganglia. Methods： Fifty patients with middle-volume intracerebral hemorrhage in the basal ganglia were divided into micro-invasive group （n=31） and conservative group （n=l 9） according to the choice ofpatients or their closest family members. The micro-invasive group was given minimally invasive puncture while the conservative group was given the routine conservative treatment. The GCS score at 1 week after onset, hematoma volume, complications, hospital mortality, duration of hospitalization, the ADL score after three months were compared between the 2 groups. Results： Compared with the conservative group, remarkable increase of GCS score, a significant decrease in hematoma volume and shorter hospital stay （P〈0.05） were observed in the micro-invasive group. However, the incidence ofrebleeding, hospital mortality and the ADL score showed no significant difference between the two groups after 3 months. Conclusion： The minimally invasive puncture treatment can improve the consciousness of patients with the middle-volume intracerebral hemorrhage and decrease the volume of hemorrhage.