不同手术时机对高血压性脑出血患者预后及生存质量的影响

Effects of different operation time on prognosis and quality of life in patients with hypertensive intracerebral hemorrhage

目的评价不同手术时机对高血压性脑出血患者预后及生存质量的影响。方法选取2011年1月～2013年1月我科收治的高血压性脑出血患者110例,两组患者均行大骨瓣开颅血肿清除术,按照不同的手术时机分为超早期组(52例)和早期组(58例),比较两组患者的预后及生存质量。结果两组患者的术后再出血率比较无统计学差异(P>0.05),超早期组患者的死亡率(9.62%)显著低于早期组(17.24%),超早期组患者的GOS预后评分良好率及生存质量显著高于早期组(P均<0.01)。结论对于需行大骨瓣开颅血肿清除术的患者,发病6 h内行超早期手术可有效降低脑出血患者的死亡率,改善预后,提高其生存质量。

Objective To evaluate the effects of different operation time on prognosis and quality of life in patients with hypertensive intracerebral hemorrhage （HICH）. Methods Randomized and controlled design was as followed. 110 cases with HICH were divided into the super-early group（n = 52） and early group（n = 58） according to the different time from Jan. 2011 to Jan. 2013, and both of the two group were treated with large invasive craniotomy. To compare the prognosis and quality of life of the two groups. Results There was no statistical difference on rehaemorrhagia after operation between the two groups at the surgery latter 3 days （P 〉 0.05 ）. After 3 month of operation, the death rate in the super-early group（9.62%） were lower than in the early group（17.24）. The fineness rate of GOS sores and WHO- QOL-BREF sores in the super-early group were higher than in the early group, which was significantly different （P 〈 0.01）. Conclusion The super-early operation of large invasive craniotomy is an effective method to reduce the death rates and to improve the prognosis and quality of life of patients with hypertensive intracerebral hemorrhage.