摘要
目的评价微创穿刺血肿粉碎清除术与小骨窗开颅血肿清除术治疗基底节区脑出血(30～80 ml)的不同效果。方法采用多中心、随机对照的临床试验方法,将304例患者分为微创穿刺血肿粉碎清除术(治疗组)和小骨窗开颅血肿清除术(对照组),评价两组患者治疗14天时神经功能缺损程度和日常生活活动能力(ADL);治疗3个月时ADL以及3个月和住院期间的病死率。结果治疗14天时,患者神经功能缺损程度和ADL两组间差异无显著性意义。治疗3个月时,ADL达自理水平的良好状态者,两组有显著性差异(x2=3．95,P<0．05),治疗组优于对照组。但是,两组间总体神经功能改善无显著性差异。治疗组3个月时病死率明显低于对照组(x2=5．35,P= 0．02),但住院期间两组的病死率无显著性差异。结论治疗组与对照组比较,患者神经功能评分总体无显著性差异,但治疗组可明显降低患者3个月的病死率。
Objective To evaluate and compare the curative effect between the microinvasive craniopuncture therapy and the clearance of hematoma by craniotomy with small bone flap in treating patients with 30 - 80 ml hemorrhage in the basal ganglion part of the brain. Methods A multi-center, randomized case-control method was used in the study. The main indexes of evaluation were the neurological impairment degree on the 14th day after treatment, activities of daily living （ADL） by the end of the third month, and the case fatality during 3 months. Results 304 patients with intracerebral hemorrhage were randomly divided into two treatment groups. The main results were as follows： ① On the 14 th day after treatment, there was no significant difference between the two groups in neurological function. ② By the end of the third month, there was significant difference in favorable outcomes （Barthel index ≥195） between the two groups （ x^2 = 3.95, P 〈 0.05）, which showed a better prognosis in microinvasive craniopuncfure （treatment） group, although there was no significant difference in improving the neurological functions and ADL. ③There was remarkable decrease in case fatality by the end of the third month in the treatment group, with statistically significant difference between the two groups（ x^2 = 5.35, P = 0.02 ）. Conclusion There was no remarkable difference in the general curative effect between the microinvasive craniopuncture and the clearance of hematoma by craniotomy with small bone flap, but the microinvasive craniopuncture decreased the case fatality by the end of the third month.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2007年第3期173-176,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
卫生部科学研究基金资助(2002-2-008)
关键词
脑出血
穿刺术
血肿
随机对照试验
cerebral hemorrhage
punctures
hematoma
randomized controlled trials
