三种不同手术方法治疗基底节区脑出血比较

目的 比较三种不同手术方法治疗基底节区脑出血的效果.方法 133例基底节区脑出血外科治疗患者：（1）传统手术组30例;（2）显微手术组36例;（3）微创手术组67例.患者昏迷状态按GCS（Glasgow Coma Scale）标准分别为5～9分,手术时机在出血后6～72h,出血量33～96ml.各组死亡率和术后6个月的ADL（Activities of daily living score）评定进行比对.结果 传统手术组、显微手术组、微创手术组死亡率分别为53.3%、25.0%和28.3%.生存质量由高到低依次是显微手术组、微创手术组和传统手术组.结论 显微手术组是目前比较好的手术方法,微创手术组比较简便、实用、便于在基层医院推广,传统手术组死亡率高、预后差.

Comparison of Three Different Surgical Treatments on Basal Ganglionic Haematomas

Objective To compared the effects of three different surgical treatments on basal ganglionic haematomas.Methods 113 cases of basal ganglionic haematomas treated by(1) traditional craniectomy(30cases),(2) microsurgical craniectomy(36cases) and(3) minimal acupuncture aspiration(67cases).The patients were scored according to Glasgow coma scale(GDS) from 5 to 9 scale and hematomas were evacuated from 6 hour to 72 hour after onset of bleeding.The bleeding volume was at range 33 to 96 ml.Outcome was evaluated by mortality and activities of daily living score(ADL) 6 months after surgery.Results The mortality for traditional craniectomy,microsurgical craniectomy and minimal acupuncture aspiration was 53.3%,25.0% and 28.3% respectively.ADL from high to low is microsurgical craniectomy,minimal acupuncture aspiration,and traditional craniectomy in order.Conclusions Microsurgical craniectomy is better than traditional one,minimal acupuncture aspiration is a simple and practicable in the primary hospital.