微创穿刺术和传统开颅术治疗高血压基底节区脑出血的对比研究

目的比较微创穿刺术和传统开颅术治疗高血压基底节区脑出血的效果。方法观察我院2005年1月～2011年3月微创穿刺术（53例）和开颅血肿清除术（43例）治疗高血压基底节脑出血患者术后并发症、死亡率、近期（术后1个月）和远期（术后6个月）预后的随访结果,并进行统计学分析（P〈0.05有统计学意义）。结果术后再出血、肺部感染、癫痫等并发症、死亡率、近期预后优良率、远期预后优良率在微创组和开颅术组中分别为：7.5%和23.2%、77.3%和93.0%、3.7%和23.2%、9.4%和25.6%、37.7%和18.6%、56.6%和34.8%,差异有统计学意义（P〈0.05）。微创组及开颅组患者术后颅内感染的发生率分别为1.8%和2.4%,两者差异无统计学意义（P〉0.05）。结论微创穿刺术治疗高血压基底节区脑出血较传统开颅血肿清除术具有更好的疗效。

Comparative study of surgical treatment between mini-invasive puncture and conventional open craniotomy for hypertensive intracerebral hemorrhage in the basal ganglia

Objective To compare the curative effect between mini-invasive puncture and conventional open craniotomy in treating patients with hypertensive intracerebral hemorrhage(HICH) in the basal ganglion.Methods Clinical data of 96 patients with HICH in the basal ganglia from January 2005 to March 2011 in our hospital were collected.The data was divided into the following two groups according to method of operation: the mini-invasive puncture(53 cases) and conventional open craniotomy(43 cases).The complications,mortality,the good prognosis rate of 1 month and 6 month after operation between two surgical treatments were compared by statistical analyses.Results Among 53 patients with the mini-invasive puncture and 43 patients with the conventional open craniotomy,the post-operative rehemorrhage rate was 7.5% and 23.2%,the pulmonary infection rate was 77.3% and 93.0%,the epilepsy rate was 3.7% and 23.2%,the mortality was 9.4% and 25.6%,the good prognosis rate was 37.7% and 18.6%(1 month after operation),56.6% and 34.8%(6 month after operation) respectively in the mini-invasive puncture group and the conventional open craniotomy group.There was significant difference between the two groups(P < 0.05).The post-operative Intracranial infection rate was 1.8% and 2.4%.There was no significant difference between the two groups(P > 0.05).Conclusion The mini-invasive puncture has better curative effect than the conventional open craniotomy in treating patients with HICH in the basal ganglion.