影响高血压脑出血外科手术预后因素的分析

Analyse the factors affect the prognosisfor patients received surgical operation caused by hypertensive cerebral hemorrhage

目的探讨影响高血压脑出血手术治疗患者预后的因素。方法回顾性分析手术治疗的41例高血压脑出血患者的临床资料。结果本组死亡11例,总死亡率为26.8%。术前GCS 3～5分患者的死亡率为58.3%(7/12),GCS 6～8分患者的死亡率为22.2%(4/18),GCS 9～12分11例无1例死亡。对存活者6个月随访,按照ADL评分:Ⅰ级4例(13.3%),Ⅱ级7例(23.3%),Ⅲ级10例(33.3%),Ⅳ级7例(23.3%),Ⅴ级2例(6.6%)。结论术前GCS及出血部位和血肿量与手术治疗高血压脑出血患者预后相关;根据不同的出血量及出血部位选择适当的手术方式以及围手术期并发症的有效控制可以明显降低病人的死亡率。

Objective To investigate the factors affect prognosisfor patients received surgical operation caused by hypertensive cerebral hemorrhage.Methods Retrospectively anlyze clinic datas of41patients received surgical operation caused by hypertensive cerebral hemorrhage.Results 11 patients were dead caused by hypertensive cerebral hemorrhage,the D / Twas 26.8%.Mortality for patients who ＇s GCS scored 3 ～ 5 before operation was 58.3%（7 /12）,GCS scored 6 ～ 8 were 22.2%（4 /18）,when GCS scored 9 ～ 12 no patient dead.Follow up the survivorswho lived six months,according to ADLscore： 4escas in grade（13.3%）,7cases in gradeⅡ（23.3%）,10casesin gradeⅢ（33.3%）,7cases in gradeⅣ（23.3%）,2cases in grade（6.6%）.Conclusions Prognosis was correlated to Preoperative GCS,bleeding part and hematoma capacity.Choose reasonable operate modus according to haemorrhage and bleeding part and control the complication in perioperative period could obviously reduce the mortality.