老年人小脑出血破入脑室患者行侧脑室外引流术与开颅手术的疗效比较

摘要

目的 探讨老年人小脑出血破入脑室行侧脑室外引流术与开颅手术的疗效比较.方法 选择小脑出血破入脑室行侧脑室外引流术的患者38例(引流组),随机抽取同期小脑出血破入脑室行开颅手术的患者46例(对照组),在死亡率及患者日常生活活动能力量表分级等方面分析此种治疗方法 的效果.结果 引流组患者随诊6个月,恢复良好28例(73.7%),死亡6例(15.8%),对照组患者随诊6个月,恢复良好32例(69.6%),死亡6例(17.4%),差异无统计学意义.结论 侧脑室外引流术是老年人小脑出血破入脑室患者行之有效的治疗方法,甚至在多数情况下可以替代开颅手术.%Objective To compare the efficacy of ventricular drainage and suboccipital craniectomy in treatment of elderly patients with hypertensive cerebellar hemorrhage(HICH) breaking into ventricles.Methods Thirty-eight elderly patients with HICH breaking into ventricles who accepted ventricular drainage in our hospital between July 2005 and July 2010(drainage group) were studied retrospectively.Forty-six elderly patients with HICH breaking into ventricles who accepted suboccipital craniectomy served as controls(control group).The clinical efficacy of the two groups was compared in respects of mortality and activities of daily life(ADL) grade.Results All patients were followed up for 6 months.Twenty-eight patients(73.7 ％) in the drainage group had good prognosis(ADL grade 1-3),and 6 patients(15.8％) died.In contrast,32 patients(69.6％)in the control group had good prognosis and 6 patients(17.4％) died.There was no significant difference between the drainage group and the control group in mortality and ADL grade.Conclusion Ventricular drainage is an effective treatment for elderly patients with HICH breaking into ventricles,even in most instances it can substitute for suboccipital craniectomy.