微创碎吸术及小骨窗手术治疗基底节区脑出血的疗效比较

Comparative Efficacy of Minimally Invasive Hematoma Aspiration and Hematoma Evacuation by Small Bone Window in the Patients with Hypertensive Basal Ganglia Hemorrhage

目的比较微创血肿碎吸术及小骨窗经外侧裂血肿清除术治疗基底节脑出血的疗效。方法高血压基底节脑出血（30-70ml）84例,采用二种手术方法 ,其中微创血肿碎吸术（微创组）43例,小骨窗经外侧裂血肿清除术（小骨窗组）41例。对两组患者的近远期疗效、日常生活能力（ADL）、死亡率、血肿清除率及并发症进行评价。结果治疗21d后微创组的并发症发生率明显少于小骨窗组（P〈0.05）,3月后随访患者生活能力评定（ADL）微创组优于小骨窗组（P〈0.05）,死亡率二组无明显差异。结论微创颅内血肿清除术能减少患者的并发症,可提高患者的日常生活能力。

Objective To compare efficacy of the minimally invasive bematoma aspiration and hematoma evacuation through lateral fissure by small bone window in the patients suffered with hypertensive basal ganglia hemorrhage. Methods The hypertensive basal ganglia hemorrhage （30-70ml） in 84 cases were treated with two kinds of surgical operation, including minimally invasive hematoma aspiration with the help of fibrinolytic agents （minimally invasive group） in 43 cases and hematoma evacuation through lateral fissure by small bone window （small bone window group） in 41 eases. They were evaluated on short and long term efficacy, activities of daily living （ADL）, mortality, Hematoma evacuation rate and complication rate in two groups. Results The incidence of complications in minimally invasive group was significantly less than that in small bone window group （p 〈0.05）, the evaluation of ADL in minimally invasive group was better than that in small bone window group （p 〈0.05） in the 3 months follow-up, and there was no significant difference of mortality between two groups.Conclusion Minimally invasive intraeranial hematoma aspiration can reduce complications and improve the ADL.