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目的比较内囊区小血肿早期立体定向治疗与保守治疗的临床疗效。方法选择肌力在1~2级的60例内囊区小血肿患者按入院先后顺序随机分两组,每组30例,分别行早期立体定向血肿排空术和保守治疗。结果按日常生活能力(ADL)分级:立体定向组Ⅰ级19例,Ⅱ级8例,Ⅲ级3例,无死亡病例。保守治疗组Ⅰ级8例,Ⅱ级9例,Ⅲ级7例,Ⅳ级5例,死亡1例(3.3%),随访1~6个月,立体定向组恢复良好率90%,致残率10%。保守治疗组恢复良好率58.6%,致残率41.4%。两组ADL能力、致残率方面差异有显著统计意义,P<0.01。结论立体定向治疗内囊区小血肿,定位准确,创伤小,神经功能恢复快,其临床疗效明显优于内科保守治疗,可以降低致残率,提高患者生存质量。
Objective To compare the clinical effects of early stereotactic and conservative treatment of small hematoma in the inner sac. Methods Sixty patients with internal hematoma of small hematomas who had muscular strength of 1 ~ 2 grade were randomly divided into two groups (n = 30 in each group), followed by early stereotactic hematoma evacuation and conservative treatment. The results were graded according to daily living ability (ADL): Stereotactic group Ⅰ grade 19 cases, Ⅱ grade 8 cases, Ⅲ grade 3 cases, no deaths. In the conservative treatment group, there were 8 cases in grade Ⅰ, 9 cases in grade Ⅱ, 7 cases in grade Ⅲ, 5 cases in grade Ⅳ and 1 case died in 1 case (3.3%). The recovery rate was 90% in stereotactic group 10%. Conservative treatment group good recovery rate of 58.6%, mutilation rate of 41.4%. There was significant difference in ADL ability and morbidity between the two groups (P <0.01). Conclusion Stereotactic treatment of small hematoma in the internal capsule area, accurate positioning, small trauma, rapid recovery of nerve function, the clinical efficacy was significantly better than the conservative treatment of internal medicine, can reduce the morbidity and improve patient quality of life.