微创穿刺术与小骨窗开颅术治疗中等量高血压脑出血的疗效比较

目的评价微创穿刺术与小骨窗开颅血肿清除术治疗中等量基底节区高血压脑出血的效果。方法按随机数字表法将95例中等量（30．60ml）高血压基底节区脑出血患者随机分为微创穿刺血肿粉碎清除术（穿刺组，49例）和小骨窗开颅血肿清除术（开颅组，46例），评价两组患者神经功能缺损程度（Nm）、日常生活活动能力（ADL）、住院期间的死亡率及并发症。结果①治疗第14天时，患者NID和ADL两组间无显著差异（P〉0．05），但患者住院期间的并发症发生率差异显著（P〈0．05），穿刺组少于开颅组。②治疗3个月后随访，ADL达自理水平的良好状态者（Barthel指数≥95），两组有显著性差异（P〈0．01），患者ADL（MRS量表）两组有显著性差异（P〈0．01），穿刺组优于开颅组。两组的死亡率无显著性差异。结论与小骨窗开颅血肿清除术相比，微刨穿刺术可明显减少中等量（30～60m1）高血压基底节区脑出血患者并发症的发生，可提高患者日常生活活动能力，降低病残率。

A Comparison of Curative Effect of Microtraumatic Craniopuncture on Patients with Moderate Hypertensive Cerebral Hemorrhage with Small Bone Window Craniotomy

Objective To compare the curative effect of the microtraumatic craniopuncture on patients with moderate hypertensive hemorrhage in the basal ganglia region to the removal of hematoma by craniotomy with small bone window. Methods Ninety-five patients with hypertensive basal ganglia region hemorrhage, of which, volume ranged from 30 ml to 60 ml, were randomly divided into both the craniopuncture （49 cases） and small bone window craniotomy （46 cases） groups. The neurological impairment degree （NID）, activities of daily living （ADL）, the incidence of complications, and the mortality were compared between both the groups. Results ①There was insignificant difference in the NID and the ADL between both the groups 14 days after the operation, The incidence of complications was significantly lower in the craniopuncture group than that in the craniotomy group （P〈O.05）.②There was significant difference in Barthel index between both the groups （P〈0.01） 3 months after the treatment. There was insignificant difference in the mortality between both the groups. Conclusions It is suggested that the curative effect of microtraumatic craniopuncture on the patients with moderate hypertensive hemorrhage in the basal ganglia region is better than that of the removal by small bone window craniotomy. The microtraumatic craniopuncture may significantly reduce the incidence rate of complications, and improve the ADL and decrease disabed rate in patients with moderate hemorrhage （30-60 ml） in the basal ganglia region.