基底节脑出血开颅手术及钻颅抽吸治疗疗效比较.docVIP

基底节脑出血开颅手术及钻颅抽吸治疗疗效比较 　【摘要】 目的 比较基底节脑出血开颅手术治疗与钻颅抽吸治疗的有效性与安全性。方法 回顾性分析我院近5年来基底节出血行外科开颅治疗和钻颅抽吸治疗的所有病例，应用统计学方法进行疗效比较。结果 共136例基底节出血病例，其中30例行外科开颅清除血肿治疗，106例行钻颅抽吸治疗。两组病例在年龄、出血量、意识状态等预后影响因素方面差异无统计学意义（Pgt;0.05）。基底节出血开颅手术治疗有效性与安全性与钻颅抽吸治疗相比差异无统计学意义（Pgt;0.05）。结论 基底节出血外科开颅治疗有效性与安全性并不优于钻颅抽吸治疗。 【关键词】 脑出血；基底节；开颅手术；钻颅抽吸治疗 Comparison of the therapeutic effect between open craniotomy and aspiration by drilling cranium for basal ganglia hemorrhage in 136 cases ［Abstract］ Objective To compare the safety and the effectiveness of surgical treatment between open craniotomy and aspiration by drilling cranium for intracerebral hemorrhage in the basal ganglia.Methods Medical history and CT scans of 136 inpatients with intracerebral hemorrhage in the basal ganglia subjected to surgical treatment were retrospectively reviewed.The safety and the effectiveness between two surgical treatments were compared by statistical analysis.Results Among 136 patients with intracerebral hemorrhage in the basal ganglia，30 patients were treated with open craniotomy，and 106 patients were subjected to aspiration by drilling cranium.Risk factors affecting prognosis，such as age，hemorrhage size，initial level of consciousness and so on，were compared in both groups.There was no significant difference in the safety and the effectiveness between two surgical treatments （Pgt;0.05）.Conclusion Surgical treatment by open craniotomy for intracerebral hemorrhage in the basal ganglia do not excel aspiration by drilling cranium in the safety and effectiveness. ［Key words］ intracerebral hemorrhage; basal ganglia;craniotomy；aspiration by drilling cranium 自发性脑出血作为临床上常见的中风类型之一，其死亡率和致残率均较高。多年来人们一直致力于探索对其有效的治疗方法，然而所得结果却各不相同，以致目前国内外在脑出血治疗方法的选择上仍无一致性见解［1～3］。本研究将近5年来在我院行开颅手术治疗和钻颅抽吸治疗基底节出血的病例进行回顾性总结，比较基底节出血两种手术疗法的有效性与安全性。 1 资料与方法 1.1 一般资料 2001年1月1日～2006年3月1日病案室病案首页数据库中所有自发性基底节出血行外科开颅治疗和钻颅抽吸治疗的病例共136例。其中30例行外科开颅清除血肿治疗，手术时间为发病后4 h～6天，中位数为24 h。106例行钻颅抽吸治疗，抽吸时间为发病后2 h～13天，中位数为72 h。30例（男24例，女6例）行开颅手术治疗患者，平均年龄（57±9）岁，出血量20～82 ml，平均（60±