高血压脑出血颅内血肿微创清除术手术时机与治疗效果的比较分析

Comparative study of operative timing and treatment effect of minimally invasive surgery for intracranial hematoma in hypertensive cerebral hemorrhage

目的探讨高血压脑出血患者进行颅内血肿微创清除术中不同手术时机与治疗效果的关系。方法将170例高血压脑出血患者按照发病至手术时间的不同分成A组（〈8 h）57例、B组（8-24 h）58例及C组（〉24 h）55例,三组患者均行颅内血肿微创清除术,比较三组患者病死率及血肿完全清除率,随访3个月,比较三组患者术后神经功能恢复情况。结果三组患者病死率组间比较无显著性差异（P〉0.05）;A组血肿清除率（91.23%）明显高于B、C组;A组术后3个月神经功能缺损评分（20.9±4.6）明显低于B、C组,A组轻度病残率（60.38%）明显高于B、C组,重度病残率（18.87%）明显低于B、C组（P〈0.05）。结论高血压脑出血患者确诊后应尽早（发病8 h内最佳）行微创颅内血肿清除术,有助于提高血肿完全清除率,促进神经功能恢复,提高生存质量。

【Objective】To study the relationship of operative timing and treatment effect of minimally invasive surgery for intracranial hematoma in hypertensive cerebral hemorrhage. 【Methods】170 patients with hypertension cerebral hemorrhage according attack to operation time were divided into group A 57 cases（8 h）, group B 58 cases（8 h-24 h）, group C 55 cases（〉24 h）, three groups of patients were performed for removal of intracranial hematoma minimally invasive, Case fatality rate, hematoma clearance rate, postoperative 3 months neural functional recovery between three groups were compared. 【Results】There were no statistical difference of case fatality rate between three groups（P〉 0.05）; Group A hematoma clearance rate（91.23%） was significantly higher than group B and C; After 3 months, group A nerve function defect score（20.9±4.6） was lower than that group B and C, group A mildly invalidism rate（60.38%） was significantly higher than group B and C, severe invalidism rate（18.87%） was lower than that group B and C（P〈 0.05）.【Conclusions】Minimally invasive surgery for intracranial hematoma intracranial appeared to be an effective treatment with hypertensive cerebral hemorrhage, after onset 8 h surgical treatment help to improve hematoma clearance rate, promote the nerve functional recovery, improve the quality of survival.