高血压脑出血手术时机的研究

Operation opportunity for surgery of hypertensive intracerebral hemorrhage

目的探讨高血压脑出血的最佳手术时机。方法将250例高血压脑出血手术病例按发病—手术间隔时间分为<7 h、7～24 h和>24 h 3组,分别进行术后并发症、近期疗效、远期疗效比较。结果 3组近期疗效(COS评分)及远期疗效(Barthel评分)差异无统计学意义(P>0.05)。<7 h组中有37例(39.8%)术后血肿复发或增大,高于7～24h组(11.4%)和>24h组(7.2%)(P<0.05);>24h组中上消化道出血、肺部感染发生率(98.5%)高于<7 h组(52.7%)和7～24h组(53.4%)(P<0.05);3组近、远期疗效差异无统计学意义(P>0.05)。结论脑出血发病后早期(7～24 h)是最佳的手术时机。

Objective To explore the optimal operation opportunity for surgery of hypertensive intracerebral hemorrhage（HICH）.Methods According to the time course of surgery,250 cases of HICH were divided into 3 groups of7h group,7～24h group and24h group.Surgery associated complications,short term outcomes and long term outcomes were compared retrospectively.Results There was no significant difference for the short term and long term outcomes among three groups（P0.05 ）.In the7h group,there were 37cases（39.8%） happened with recur hemorrhage,the risk of recur hemorrhage was higher than other two groups（P0.05）.In the24h group,the incident of upper gastrointestinal bleeding and pulmonary infection were higher than other two groups（P0.05 ）. Conclusion The early stage（7～24h） was the optimal operation opportunity for surgical treatment of HICH.