保守治疗与手术治疗对少量大脑半球高血压脑出血患者的影响

Effect of conservative and surgical treatment on smaller cerebral hemorrhage

目的比较内科保守治疗、小骨窗手术治疗以及立体定向手术治疗对少量(20～30ml)高血压脑出血预后的影响。方法入选病人根据随机原则分成三组,一组使用立体定向穿刺治疗高血压脑出血,另一组采用小骨窗开颅血肿清除术,直接清除血肿,最后一组采用内科保守治疗。比较其改善预后、平均住院时间和住院费用。结果立体定向穿刺血肿抽吸术可以改善预后,明显缩短住院日以及节省费用,与其他两组比较具有高度显著性差异(P均<0.01)。结论血肿量在20～30ml的大脑半球脑出血患者,选择立体定向穿刺血肿抽吸术,疗效优于小骨窗开颅治疗以及内科保守治疗。

Objective To compare the effect of medical conservative treatment, microsurgery through small skull window and stereotactic surgery on smaller（20-30 ml） cerebral hemorrhage. Methods All patients were divid- ed into three groups randomly, namely, the microsurgery group, the stereotactic group and the medical treatment group. The improving outcomes, average hospitalization time and the hospitalization expenses of the three groups were compared. Results Stereotactic surgery can improve outcomes as well as shorten the hospitalization days and decrease the cost. There was statistical difference in all the comparisons（ P 〈0.01）. Conclusion It is better to choose ster- eotactic surgery treatment than medical conservative treatment and microsurgery through small skull window for pa- tients with hematoma between 20 ml and 30 ml.