不同手术时机的颅内血肿微创清除术治疗急性脑出血的疗效研究

The Curative Effect of Different Operation Time of Minimally Invasive Surgery of Intracranial Hematoma for Treatment of Acute Cerebral Hemorrhage

目的:探讨颅内血肿微创清除术治疗急性脑出血的最佳时机,提高临床治疗水平。方法:选取我院自2007年3月至2010年7月收治的120例急性脑出血患者作为研究对象,按照发病后行颅内血肿微创清除术治疗时间分为A组(6h)、B组(12h)、C组(24h)、D组(48)各30例,比较四组患者血肿完全清除率、血肿复发率、术后3个月神经功能恢复及并发症情况。结果:①A、B组与C、D组患者血肿完全清除率、血肿复发率比较差异显著(P<0.01),具有统计学意义。②术后3个月神经功能恢复情况4组间比较均有显著差异(P<0.01),A组重度病残率均较其他三组低(P<0.01),具有统计学意义。③四组患者并发症发生情况比较差异不大(P>0.05),无统计学意义。结论:早期(≤6h)内行颅内血肿微创清除术可提高患者血肿清除率、降低血肿复发率,同时可改善患者神经功能恢复和预后,对提高患者术后生存质量具有重要价值。

Objective： To explore the best time of minimally invasive surgery of intracranial hematoma on the treatment of acute cerebral hemorrhage,for improving the clinical treatment.Method： Selecting 120 cases of acute cerebral hemorrhage in our hospital from Mar.2007 to Jul.2010 as research object,in accordance with the onset after minimally invasive treatment of intracranial hematoma removal time,they were divided into group A（6h）,group B（12h）,group C（24h）,group D（48）,each for 30 cases,to compare the complete evacuation of hematoma clearance rate,the rate of hematoma recurrence,3 months postoperative neurological function recovery and complications of the 4 groups.Result： ①The difference of complete clearance rate,hematoma recurrence rate between group A,B and group C,D was significant.（P0.01）.②After 3 months of rehabilitation of nerve function between the 4 groups had significant difference（P 0.01）,group A with severe morbidity were compared with the other three groups（P 0.01）,low statistical significance.③The difference of complications between the four groups had no statistical significance.（P0.05）.Conclusion： Early（less than 6h） expert of minimally invasive surgery of intracranial hematoma patients not only can improve hematoma clearance rate,reduce the rate of relapse hematoma,but also can improve the recovery of nerve function and prognosis of patients at the same time.It has important value of improving the quality of life for postoperative patients.