小骨窗开颅显微手术时机对高血压脑出血患者疗效、神经功能及生存质量的影响

Effects of operation time of small skull-window craniotomy on curative effect,nerve function and life quality in patients with hypertensive intracerebral hemorrhage

目的探讨小骨窗开颅显微手术不同手术时机治疗对高血压脑出血患者疗效、神经功能及生存质量的影响。方法 90例符合纳入标准的高血压脑出血患者根据发病至手术时间不同分为超早期组（≤6h,n=45）和早期组（6-24h,n=45）。比较术后患者疗效、神经功能及生存质量。结果术后,早期组再出血率、病死率及GOS评分优良率分别为13.3%、26.7%和68.9%,超早期组分别为8.9%、6.7%和88.9%。在术后再出血率方面,2组比较无统计学差异（P〉0.05）。与早期治疗组相比,超早期组患者病死率明显降低,GOS评分优良率明显增加,差异均有统计学意义（P均〈0.05）。治疗后,与早期组相比,超早期组治疗后3周和6周的SSS评分均明显降低,治疗后3个月和6个月的生存质量评分均明显升高差异有统计学意义（P均〈0.05）。结论超早期小骨窗开颅显微手术能降低患者的病死率,提高疗效,改善神经功能和生存质量,值得临床推广。

Objective To investigate the effects of different operation time on curative effect, nerve function and life quality in patients with hypertensive intracerebral hemorrhage（HICH）. Methods Ninety cases of HICH meeting the inclusion criteria were divided into super-early group（〈6 h, n=45） and early group（6-24 h, n=45） according to the period time from the onset of the disease to the operation. The curative effect, nerve function and life quality of two groups were compared. Results After operation, the rehaemorrhagia rate, mortality and excellent rate of Glasgow Outcome Scale （GOS） score were 13.3 %, 26.7% and 68.9% in the early group and 8.9%, 6.7% and 88.9% in the super-early group. There was no statistical difference in the rehaemorrhagia rate between two groups （P〉0. 05）. Compared with the early group, there were lower mortality rate and higher GOS score in the super-early group（P〈0.05）. Compared with the early group, there were lower SSS score （3 weeks and 6 weeks after operation） and higher life quality in the super-early group （3 months and 6 months after operation） （P 〈0.05）. Conclusion Super-early small skull-window craniotomy can lower mortality rate, improve curative effect and life quality in patients with HICH, which is worthy of application.