超早期大骨瓣开颅血肿清除术对高血压性脑出血患者远期疗效和日常生活活动能力的影响

Effects of super-early large invasive craniotomy on prostecdtive efficacy and activities of daily living of patients with hypertensive intracerebral hemorrhage

目的评价超早期大骨瓣开颅血肿清除术对高血压性脑出血患者远期疗效和日常生活活动(activities of daily living,ADL)能力的影响。方法选取2009年1月—2010年4月在我科收治的高血压性脑出血患者122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(45例)和早期组(77例),其中两组各取前45例患者进行为期三年的随访,比较两组患者的远期疗效和ADL能力。结果对两组患者均随访3年,超早期组患者的远期疗效优良率达到82.22%,显著高于早期组的64.44%(P<0.01);超早期组患者的ADL能力评级优良率为76.19%,显著高于对照组的63.16%(P<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提高高血压性脑出血患者的远期疗效和ADL能力。

Objective To evaluate the effects of super-early large invasive craniotomy on prostecdtive efficacy and the activities of daily living （ADL） of patients with hypertensive intraeerebral hemorrhage （HICH）. Method Randomized and controlled design was as followed. 90 cases with HICH were divided into a super-early group（ n =45 ）and an early group（ n = 77） admitted to the hospital during the period from January, 2009 to April, 2010. Both groups were treated with large invasive craniotomy. Compared the prostecdtive efficacy and ADL of the two groups after 3years of follow-up. Findings After 3 years of operation follow-up, the fineness rate of prostecdtive efficacy in the super-early group（82.22% ） was higher than that in the early group（64.44% ） , and the fineness rate of ADL sores in the super-early group（76.19% ） was higher than that in the early group（63.16% ） （P 〈 0.01 ）. Conclusion The super-early operation of large invasive craniotomy is an effective method to improve the prostecdtive efficacy and activities of daily living of patients with hypertensive intracerebral hemorrhage.