目的：分析比较微创钻孔引流术与小骨窗开颅术治疗不同出血量的高血压基底节区脑出血的临床疗效。方法随机将118例高血压基底节区脑出血患者分为微创组和开颅组。微创组（ n＝61例）行微创钻孔引流手术（微创A组：34例，出血量﹤45 mL。微创B组：27例，出血量≥45 mL）。开颅组（ n＝57例）行小骨窗开颅手术（开颅A组：28例，出血量﹤45 mL；开颅B组：29例，出血量≥45 mL）。分别比较两种手术方案的治疗效果。结果术后2个月，微创 A组治疗总有效率88.24％，高于开颅 A组67.86％，2组比较，差异有统计学意义（P﹤0.05）；微创B组治疗总有效率（59.26％）低于开颅B组（72.41％），但组间比较差异无统计学意义（ P﹥0.05）。结论针对高血压基底节区脑出血患者，出血量﹤45 mL时行微创钻孔引流术疗效更佳，出血量≥45 mL时建议行小骨窗开颅术。%Objective To compare the clinical efficacy between micro-invasive drainage( MID)and small bone window craniotomy ( SBWC)in treating different amount of bleeding of hypertensive basalganglia region hemorrhage. Methods Clinical data of 118 patients with hypertensive basalganglia region hemorrhage who underwent surgical operation in Honghuagang District People’s Hospital of Zunyi from January 2012 to July 2014 were retrospectively analyzed,34 had intracerebral hematomas﹤45ml,and 27 ones≥45ml. Of patients with hematomas﹤45ml,34 cases were tread by MID(A-MID group)and 29 cases were tread by SBWC(A-SBWC group);Of 56 patients with hematomas≥45ml,27 cases were tread by MID(B-MID group)and 29 cases were tread by SBWC(B-SBWC group),the curative effects were compared between two kinds of operation scheme. Results Two months after operation,the total-efficiency in A-MID group was 88. 24%,which was higher than that in A-SBWC group 67. 86%(P﹤0. 05);the total-efficiency in B-MID group(59. 26%)was lower than that in B-SBWC group(72. 41%),but there is no significant difference between two groups(P﹥0. 05). Conclusion It is suggested that the hypertensive ba-salganglia region hemorrhage patients with hematomas﹤45ml should be treated by MID and the ones with hematomas≥45ml should be treated by SBWC.
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