早期立体定向置管引流治疗内囊区小血肿的临床研究

Early stage stereotactic operation used in small internal capsule hematoma

目的比较内囊区小血肿早期立体定向治疗与保守治疗的临床疗效。方法选择肌力在1~2级的60例内囊区小血肿患者按入院先后顺序随机分两组,每组30例,分别行早期立体定向血肿排空术和保守治疗。结果按日常生活能力（ADL）分级：立体定向组Ⅰ级19例,Ⅱ级8例,Ⅲ级3例,无死亡病例。保守治疗组Ⅰ级8例,Ⅱ级9例,Ⅲ级7例,Ⅳ级5例,死亡1例（3.3%）,随访1~6个月,立体定向组恢复良好率90%,致残率10%。保守治疗组恢复良好率58.6%,致残率41.4%。两组ADL能力、致残率方面差异有显著统计意义,P〈0.01。结论立体定向治疗内囊区小血肿,定位准确,创伤小,神经功能恢复快,其临床疗效明显优于内科保守治疗,可以降低致残率,提高患者生存质量。

Objective To compare the curative effects between early stage stereotaetic operation and unsurgical treatment for hypertensive small intracerebral hemorrhage located in internal capsule. Methods 60 cases（The muscle strength grading were lower than grade ]I ） of hyper- tensive small internal capsule hemorrhage were randomly divided into two groups based on admission order. There were 30 cases in each group, One group was treated with early stage stereotactic operation and the other group with unsurgical treatment. Results According to the grade of ac- tivity of daily living （ADL）,in the group of early stage stereotactic operation, there were 19 cases in grade I , 8 cases in grade II, 3 cases in grade III ; In the group of unsurgical treatment, there were 8 cases in grade I , 9 cases in grade lI, 7cases in grade HI, 5cases in grade iV, 1 cases were death （3.3%）. The follow--up surveys were done after operation within 6 months, in the group of early stage stereotactic operation,it was 90% cases recovered well, the disability rate was 10 %. In the unsurgical group, 58. 6% cases recovered well, the disability rate was 41.4%. The ability of ADL and the disability rate between two groups were significant in statistics （P〈0. 01）. Conclusion The clinical curative effects of early stage stereotactic operation is obviously superior to unsurgical treatment in the cases with small internal capsule hematoma,its rate of mutilation and mortality are lower than unsurgical treatment , meanwhile,the survival quality is higher.