丘脑出血微创穿刺与开颅手术的疗效比较分析

Comparative study on efficacy of minimally puncture and craniotomy for thalamic hemorrhage

目的分析比较丘脑出血患者微创穿刺治疗与外科开颅手术治疗的疗效。方法对1997～2009年住院经颅脑CT确诊的丘脑出血患者42例（观察组），应用YL-1型微创穿刺治疗，生存病例于治疗后半年随访，按生活能力分级进行预后评估；选2005～2009年经外科开颅手术治疗的丘脑出血患者45例（对照组），电话通知生存者来院随访，进行生活能力分级。对两组病例的评估结果进行对比分析。结果观察组的病死率为7．1％，对照组的病死率为11．1％，P〉0．05。观察组的生活能力在日常生活能力表（ADL）评估为I～Ⅲ级者为81％，对照组为60．0％，特别日常生活能力表（ADL）评估为I级者观察组为33．3％，对照组为13．3％，P〈0．05。结论微创穿刺治疗与开颅手术相比对丘脑出血患者的病死率无显著差异，但患者生存质量明显优于外科开颅手术治疗。

Objective To analyze and compare the efficacy of minimally puncture and craniotomy for patients with thalamic hemorrhage. Methods Totally 42 patients （ observation group） with thalamie hemorrhage diagnosed by brain CT during 1997 to 2009 were treated with micropuneture technique using YL-1 type smash puncture needle. The surviving patients were followed up at half a year after the treatment and their prognosis was estimated according to activities of daily living （ADL）. Another 45 patients （control group） with thalamie hemorrhage treated with craniotomy during 2005 to 2009 were selected. The surviving patients were phoned to hospital for the follow-up and they were graded by ADL. The results of the two groups were compared and analyzed. Results The death rate in observation group was 7.1% while that in control group was 11.1% , P 〉 0.05. There were 34 cases in observation group and 27 cases in control group that graded at ADL I - m. Particularly, the rate of ADL I was 33.3% in observation group compared with 13.3% in control group, P 〈0.05. Conclusion No distinct difference was observed in reducing death rate between micropuncture technique and craniotomy for thalamic hemorrhage. However, micropuncture treatment is superior in improving the life quality of patients with thalamie hemorrhage compared with craniotomy treatment.