关键词: 自发性脑出血, 立体定向技术, 保守治疗

Abstract: Objective To investigate the influences of stereotactic puncture drainage treatment and conservative treatment in clinical prognoses of patients with spontaneous intracerebral hematoma in the basal ganglia.Methods A retrospective analysis of Sixty-five patients with spontaneous basal ganglia cerebral hemorrhage(Glasgow comascale(GCS)>8 scores and hemorrhage volume 20 ml to 40 ml) admitted to our department from January 2019 to December 2021.All patients were divided into surgical group (accepted stereotactic puncture drainage with thrombolysis treatment,n=32) and conservative treatment group (n=33).The data during hospitalization and 12 months follow-up data of patients from the 2 groups were compared.The baseline general data,average hospitalization time,complications,Glasgow outcome scale (GOS) scores,modified Rankin scale (mRS) scores and modified Barthel index (MBI)were compared after treatment.Results There were no significant differences in age,gender,volume of bleeding and hypertension related factors between the 2 groups (P＞0.05).There were no significant differences in GCS on admission,one week after admission and discharge between the 2 groups (P＞0.05).The hematoma clearance rate at 1 week after admission was 87.18±4.49%,average hospitalization time was (12.13±1.75)d and the rate of pulmonary infection on admission was 25% (8/32) on admission in surgical group and that in conservative treatment group with hematoma clearance rate was 25.75±3.04%,average hospitalization day was(16.97±1.64)d and the rate of pulmonary infection on admission was 48.5%(16/33),the differences between the 2 groups were statistically significant (P＜0.05).There were significant differences in GOS scores,mRS scores and MBI between the 2 groups in the four follow-up of 1 month,3 months,6 months and 12 months afte treatment(P＜ 0.05).Conclusion The overall efficacy of stereotactic puncture drainage with thrombolysis has more obvious advantages in patients with cerebral hemorrhage volume of 20 ml to 40ml in the basal ganglia and GCS>8 scores than conservative treatment.

Key words: Spontaneous intracerebral hemorrhage, Stereotactic puncture drainage, Conservative treatment