Abstract: Objective Stereotactic hematoma puncture and drainage and craniotomy were used to retrospectively analyze the results of thalamic hemorrhage in elderly patients. Methods The elderly patients with thalamic hemorrhage treated in our department from January 2015 to December 2019 were selected as the research objects.25 cases were randomly selected from the orientation group and 25 cases from the craniotomy group.The craniotomy group was treated with clearance of thalamic hematoma,and the orientation group was treated with stereotactic hematoma puncture and drainage.The operation time,hospital stay,GCS score before and 1 week after operation,good recovery rate and mortality were compared between the two groups. Results The operation time and hospital stay in the orientation group were significantly lower than those in the craniotomy group (P<0.05).One week after operation,the GCS score of the orientation group was significantly higher than that of the craniotomy group.The rate of good recovery and mild disability in the orientation group was 64.0%,which was significantly higher than that in the craniotomy group (36.0%),and the difference was statistically significant (P<0.05).There was no death in both groups. Conclusion Stereotactic technology is accurate,minimally invasive,fast,effective and safe.It is the first choice for the treatment of thalamic hemorrhage in elderly patients.

Key words: Stereotactic, craniotomy, Advanced age, Thalamic hemorrhage, Hematoma clearance

摘要： 目的 采用立体定向血肿穿刺引流术与开颅血肿清除手术两种方法,对高龄患者丘脑出血的结果进行回顾分析其临床效果。方法 选取我科2015年1月～2019年12月收治的高龄丘脑出血患者作为研究对象,随机从定向组抽25例和开颅组抽25例。开颅组行开颅丘脑血肿清除手术,定向组行立体定向血肿穿刺引流手术,比较两组的手术时间、住院时间、术前及术后1周GCS评分、恢复良好率及死亡率。结果 定向组的手术时间、住院时间显著低于开颅组,差异有统计学意义(P＜0.05)。定向组术后1周的GCS评分显著高于开颅组,差异有统计学意义(P＜0.05)。定向组的恢复良好及轻度残疾率为64.0%,显著高于开颅组的36.0%,差异有统计学意义(P＜0.05)。两组均无死亡病例。结论 立体定向技术具有精准、微创、快捷、有效、安全的特点,对高龄患者丘脑出血的治疗首选方法。

关键词: 立体定向, 开颅手术, 高龄, 丘脑出血, 血肿清除