超早期与早期手术治疗基底节区高血压脑出血的临床疗效对比研究

Comparative Study on the Clinical Efficacy of Ultra-early and Early Surgical Treatment for Hypertensive Intracerebral Hemorrhage in Basal Nuclei Zone

目的:通过比较超早期手术与早期手术治疗基底节区高血压脑出血的临床疗效对比研究来探讨基底节区高血压脑出血的最佳手术时机.方法:回顾性分析了采取小骨窗开颅显微手术治疗基底节区高血压脑出血患者共120例,以出血后7小时内手术60例患者分为超早期手术组,出血后7～24小时手术患者60例分为早期手术组,比较两组患者术后近期并发症、死亡情况及6个月后临床疗效(用日常生活能力量表ADL评定)方面比较,数据用统计学方法处理.结果:超早期手术组患者术后近期肺部感染、消化道出血及急性肾功能衰竭明显少于早期手术组,差异有统计学意义(P<0.05);再次出血及死亡情况比较,两组无显着差异(P>0.05).两组患者术后6个月临床疗效在总有效方面比较后得出超早期手术组明显好于早期手术组,差异有统计学意义(P<0.05).结论:超早期行小骨窗开颅显微手术治疗基底节区高血压脑出血比早期手术治疗更能减少术后近期并发症并有效改善术后日常生活能力.

Objective： To investigate the optimal operation timing of hypertensive intracerebral hemorrhage in basal nuclei zone through comparative study on the clinical efficacy of ultra-early surgical treatment and early surgical treatment.Methods： The data of 120 cases of hypertensive intracerebral hemorrhage in basal nuclei zone,be treated with small bone window craniotomy microsurgery,were retrospectively analysed.60 patients who underwent surgery within bleeding 7 hours were assigned to ultra-early surgery group,60 patients who underwent surgery after bleeding 7～24 were assigned to early surgery group.The postoperative complications,death,clinical efficacy after six months（assess by activities of daily living） of the two groups were compared,and the data were dealed with statistical methods.Results： The recent lung infection,gastrointestinal bleeding and acute renal failure in ultra-early surgery group were significantly less than the early surgery group（P0.05）,but the re-bleeding and mortality didn’t have significant difference（P0.05）.For clinical efficacy after 6 month opertation,the total efficacy of the ultra-early surgery group was significantly better than the early surgery group（P0.05）.Conclusion： Ultra-early performing small bone window craniotomy microsurgery for hypertensive intracerebral hemorrhage in basal nuclei zone is better than early surgery in reducing postoperative complications and effectively improving