高血压脑出血手术时机与术后再出血相关性研究

目的对于高血压脑出血手术时机的选择对术后再出血的影响进行分析与研究。方法分析近3年来收治的52例高血压脑出血(HICH)患者手术病例,并且根据患者术后再出血的情况,对不同的手术时机的选择与术后再出血的关联性进行回顾性分析与总结。结果本组患者52例,术后再出血共9例,再出血的发生率为17.3%。该9例术后再出血患者中,发生在超早期手术(7h以内)的患者为5例,发生在8～24h内手术的患者3例,发生在24h以上手术的患者1例。该结果显示出不同的手术时机对于术后再出血的影响不同,且超早期手术对于术后再出血的影响最为显著。结论高血压脑出血经过超早期手术后发生术后再出血的几率比后期手术患者高很多,严重影响患者的预后情况。提高手术的技巧与随机应变的能力,发挥高血压脑出血超早期手术的特点,对于降低手术的危险性和致死率有着极为关键的作用。

Objective For hypertensive cerebral hemorrhage operation timing on postoperative rebleeding effect analysis and research.Methods Analysis of recent 3 years in our hospital 52 cases of hypertensive cerebral hemorrhage（HICH）patients operation case,and according to the postperative bleeding cases,depending on the timing of operation and postoperative rebleeding of relatedness were retrospectively analyzed and summarized.Results In this group of patients with 52 cases,postoperative bleeding in 9 cases,bleeding occurred in 17.3%.The 9 cases of postoperative rebleeding in patients,occurring in the super early operation（within 7 hours）in patients of 5 cases,occurs in 8 to 24 hours of operation in 3 patients,occurring in more than 24 hours of operation in 1 cases.The results show that the different timing of operation for recurrent bleeding after operation and the effects of different,and early operation for recurrent bleeding after operation has the most significant effect.Conclusion According to the group of 52 patients with hypertensive cerebral hemorrhage after records show,super early operation after the occurrence of postoperative rebleeding rate than late operation patients is much higher,serious impact on the patient＇s prognosis.Thus,improve the operation skills and ability to adjust to changing circumstances,play of hypertensive cerebral hemorrhage by early operation characteristics,to reduce the operation risk and mortality rates have a pivotal role.