个性化手术治疗基底节区出血临床分析

Clinical analysis of individualized surgical treatment for basal ganglion hemorrhage

目的总结分析不同手术治疗方式治疗基底节区出血的疗效及预后。方法对血肿穿刺引流术、小骨窗血肿清除术及开颅去骨瓣减压血肿清除术三种手术方式治疗245例基底节区出血（血肿≥30 ml）患者的临床资料进行回顾分析。结果近期疗效：术后6-72 h复查头CT,血肿清除〉90%者225例,≤90%者20例。术后3 d内再出血19例（7.8%）、术后1个月死亡11例（4.5%）。远期疗效：术后6个月随访226例,失防率7.8%。格拉斯哥预后评分（GOS）4-5分177例（78.3%）,2-3分36例（15.9%）,死亡13例（5.8%）。结论采用个性化的手术方式有助于提高基底节区出血的手术治疗效果,可在临床广泛应用。

To summarize and analyze curative effect and prognosis of different surgical methods in the treatment of basal ganglion hemorrhage.Methods A retrospective analysis was made on clinical data of 245 patients receiving hematoma puncture drainage, small bone window evacuation of hematoma, and craniotomy decompressive craniectomy evacuation of hematoma for basal ganglion hemorrhage （hematoma ≥30 ml）.Results Short-term curative effect： Reexamination of head CT was taken in postoperative 6-72 h. There were 225 cases with hematoma clear 〉90% and 20 cases ≤ 90%. There were 19 rehaemorrhagia cases （7.8%） in 3 d after operation and 11 death cases （4.5%） in 1 month after operation. Long-term curative effect： 226 cases received follow-up for 6 months, with lost rate as 7.8%. There were 117 cases （78.3%） with Glasgow outcome scale （GOS） score as 4-5 points, 36 cases （15.9%） with 2-3 points, and 13 death cases （5.8%）.Conclusion Implement of individualized surgical treatment can improve curative effect for treating basal ganglion hemorrhage. It can be widely applied in clinic.