不同时间窗神经血肿清除术治疗自发性脑出血的近期预后观察

Recent Outcomes of Spontaneous Intracerebral Hemorrhage Treated by Neurohematoma Evacuation at Different Time Windows

目的探讨不同时间窗神经血肿清除术治疗自发性脑出血对近期预后的影响。方法回顾性分析2020年5月至2021年5月我院收治的70例自发性脑出血患者的临床资料,按照发病时间的不同分成观察组与对照组,每组35例,观察组在发病6h内进行神经血肿清除术,对照组在发病6~24h内进行手术,对比两组临床疗效、神经功能缺损评分、血肿清除率、近期预后情况及并发症发生率。结果观察组临床疗效明显高于对照组(P<0.05);相较于治疗前,两组治疗后神经功能缺损评分均有明显降低(P<0.05),观察组评分明显低于对照组(P<0.05);观察组血肿清除率明显高于对照组(P<0.05);在格拉斯哥结局量表(GOS)评分方面,观察组1~2分比例明显低于对照组(P<0.05),观察组5分比例明显高于对照组(P<0.05);相较于对照组,观察组并发症发生率明显更低(P<0.05)。结论早期开展神经血肿清除术治疗自发性脑出血效果较好,可明显提高临床疗效,减少患者神经功能缺损,提高血肿清除率,改善患者近期预后,减少并发症。

Objective To investigate the effect of different time windows of neurohematoma evacuation for spontaneous intracerebral hemorrhage on the recent prognosis.Methods To retrospectively analyzed the clinical data of 70 patients with spontaneous intracerebral hemorrhage admitted to our hospital from May 2020 to may 2021,divided into an observation group and a control group according to the time of onset,35 patients in each group,an observation group underwent neurohematoma evacuation within 6h of onset,and a control group underwent surgery within 6 to 24h of onset,and compared the clinical outcomes,neurological deficit scores,hematoma evacuation rates between the two groups recent prognosis and complication rates.Results The clinical efficacy of the observation group was significantly higher than that of the control group(P<0.05);Compared with before treatment,the neurological deficit scores of both groups were significantly lower after treatment(P<0.05),and the scores of the observation group were significantly lower than those of the control group(P<0.05);The hematoma evacuation rate in the observation group was significantly higher than that in the control group(P<0.05);In terms of Glasgow Outcome Scale(GOS)scores,the observed group had a significantly lower ratio of 1 to 2 points than the control group(P<0.05),and the observed group had a significantly higher ratio of 5 points than the control group(P<0.05);The complication rate was significantly lower in the observation group compared with the control group(P<0.05).Conclusion The early development of neurohematoma evacuation for spontaneous intracerebral hemorrhage has a better outcome,which can obviously improve the clinical efficacy,reduce the neurological deficit of patients,improve the hematoma evacuation rate,improve the patient’s recent prognosis,and reduce complications.