高血压脑出血外科手术时机对临床预后的影响

The Affection of Operation Time for Hypertensive Cerebral Hemorrhage on Prognosis

目的评价高血压脑出血患者行颅内血肿清除手术的时机对临床效果的影响。方法136例高血压脑出血的患者,均行钻颅血肿清除术,按手术实施时间分为3组:A组,7小时内手术者46例;B组,8-24小时内手术者53例;C组,大于24小时手术者37例。比较3组患者术后一个月意识恢复、致残及死亡情况。结果A、B两组患者意识恢复良好者多于C组(P<0.05);A组患者致残率低于B、C组(P<0.05),B组致残率低于C组(P<0.05);3组患者死亡事件发生率无显著差异。结论高血压脑出血患者应尽早争取手术时间,早期手术可提高救治成功率,降低术后患者致残率。

Objective To evaluate the affection of operation time for hypertensive cerebral hemorrhage on prognosis. Methods 136 cases with hypertensive cerebral hemorrhage received evacuation of hematoma by drilling open the skull and they were divided into 3 groups according to the time when the operations were performed： Group A （ n = 46 ）, receiving the operations within 7 hours, Group B （ n = 53 ）, receiving the operations within 8 to 24 hours and Group C （ n = 37 ）, receiving the operations after 24 hours; the recovery of consciousness, disability and death 1 month after operation in 3 groups were compared. Results Patients in Group A and Group B showed a better recovery of consciousness than those in Group C （ P 〈 0.05 ） ; the disability rate of Group A was lower than those of Group B and Group C （ P 〈 0.05 ） while the disability rate of Group B was lower than that of Group C （ P 〈 0.05 ） ; the mortality in 3 groups was of no obvious difference. Conclusion Operations should be given to patients with hypertensive cerebral hemorrhage as soon as possible, early operation may raise the successful rate of remedy and decrease the rate of disability.