Abstract: Objective: To investigate the clinical efficacy of puncture and drainage for the treatment of spontaneous basal ganglia hematoma through a catheter at frontal region at different time window and its impact on brain edema. Methods: A total of 113 patients with spontaneous basal ganglia hematoma were divided into an ultra-early group （n=31, surgery started within 6 hours of the ictus），an early group （n=42, surgery started from 6 hours to 24 hours of the ictus） and a delayed group （n=40, surgery started from >24 hours to 72 hours of the ictus） according to the time window of surgery. The differences in incidence of common complications, the evacuation rate of blood clots, brain edema volume change, and neurological deficit scores （NIHSS） change and long-term follow-up results were compared among the three groups. Results: There were no significant differences in the incidence of common complications, residual hematoma volume, evacuation rate of blood clots and initial brain edema volume among the three groups. 7 days after the ictus perihematomal edema volume was （6.6±4.8） mL and （8.2±5.9） mL in the ultra-early and early groups, respectively. Both volumes were significantly lower than （15.8±15.4） mL in the delayed group （P<0.01）. The neurological deficit score （NIHSS） change was （11.3±6.0） and （12.5±6.3） in the ultra-early and early groups, respectively. Both changes were significantly higher than （6.3±5.4） in the delayed group （P<0.01）. Six months later, the ADL score in ultra-early and early groups was significantly more favorable than the delayed group （P<0.01）. But there were no significant differences between the ultra-early and early groups in these variables. Conclusion: The puncture and drainage through a catheter at frontal region for the treatment of spontaneous basal ganglia hematoma could remove blood clot effectively. Early surgery could alleviate the degree of perihematomal edema, improve neurological outcome and reduce the possibility of rebleeding.

Key words: 计算机辅助