超早期穿刺引流术治疗高血压性脑出血

A clinical investigation for ultra-early microtrauma drainage in the treatment of hypertensive cerebral hemorrhage

目的 评价超早期穿刺引流术治疗高血压性脑出血的疗效。 方法 将 6 1例高血压性脑出血分为超早期组 31例 (发病 6h内手术 ) ,对照组 30例 (发病 2 4h～ 1周手术 )。均行穿刺引流清除血肿。 结果 超早期组有效率 83 9% ( 2 6 /31) ,显效率 6 7 7% ( 2 1/ 31) ,均优于对照组 ( 6 0 % ,4 0 % ) ( χ2 =4 32 2 ,4 72 5 ;P =0 0 38,0 0 30 )。超早期组病死率 ( 16 1% ,5 / 31)低于对照组 ( 4 0 % ,12 / 30 ) ( χ2 =4 32 2 ,P =0 0 38)。存活患者的生存质量ADLⅠ～Ⅲ级 ( 84 6 % ,2 2 / 2 6 )与对照组 ( 5 5 6 % ,10 / 18)无统计学差异 ( χ2 =3 182 ,P =0 0 74 )。 结论 超早期微创引流术治疗高血压性脑出血较延期手术疗效好 。

Objective To evaluate the curative effect of ultra-early microtrauma drainage in the treatment of hypertensive cerebral hemorrhage. Methods Sixty-one cases of hypertensive cerebral hemorrhage were divided into two groups: the ultra-early group (31 cases; received surgery within 6 hours after the onset) and the control group (30 cases; received surgery between 24 hours and 1 week after the onset).All these cases underwent microtrauma drainage for cleaning the hematoma. Results The effective rate and the marked effective rate in the ultra-early group were 83 9% (26/31) and 67 7% (21/31),respectively,both of which were higher than those in the control group (60% and 40%; χ 2=4 322,4 725;P =0 038, 0 030).The death rate in the ultra-early group (16 1%,5/31) was lower than that in the control group (40%,12/30; χ 2=4 322,P =0 038).Of the life quality of survivors,the values of ADL Ⅰ～Ⅲ accounted for 84 6% (22/26) in the ultra-early group and 55 6% (10/18) in the control group ( χ 2=3 182;P =0 074). Conclusions Ultra-early microtrauma drainage for hypertensive cerebral hemorrhage provides better curative effect and lower death rate than postponed operation.