影像设备引导下立体定向血肿抽吸手术时机对高血压脑出血患者治疗效果的影响

Effect of Different Surgical Opportunity of CT-guided Stereotactic Aspiration for Hypertensive Intracerebral Hemorrhage Patients

目的探讨CT引导下立体定向血肿抽吸术（CTSA）手术时机对高血压脑出血患者治疗效果的影响。方法选取2013年12月~2014年10月我院收治的高血压脑出血患者180例,均行CTSA治疗,根据手术时机的不同分为早期组（≤72 h,n=118）和晚期组（〉72 h,n=62）。对比分析两组间的血肿清除率;术后1个月进行疗效评价;术后随访6个月,对比两组病死率、Barthel指数（BI）、改良Rankin量表（mRS量表）、格拉斯哥预后量表（GOS量表）评分结果。结果早期组和晚期组总有效率分别为91.53%和88.71%,两组比较无显著性差异（P〉0.05）。早期组和晚期组血肿清除率、术后6个月死亡率、BI、GOS和mRS评分比较均无显著性差异（P〉0.05）。早期组和晚期组术后1个月并发症发生率分别为22.88%和25.81%,两组比较无显著性差异（P〉0.05）。结论 CTSA治疗高血压脑出血其疗效确切,患者远期功能恢复良好,早、晚期进行手术的疗效及远期预后无明显差异。

Objective To investigate the effect of operation opportunity of CT-guided stereotactic aspiration（ CTSA） on the curative results of hypertensive intracerebral hemorrhage. Methods 180 cases of patients with hypertensive intracerebral hemorrhage in our hospital from December 2013 to October 2015 were treated with CTSA and divided into early operation group（ ≤72 h,n = 118） and advanced operation group（ 72 h,n = 62）. The hematoma clearance rate and postoperative curative results of these two groups were compared.The mortality,Barthel index（ BI）,modified Rankin scale（ mRS）,Glasgow outcome scale（ GOS） of two groups were determined as well. Results The total effective rate of early operation group and advanced operation group was 91. 53% and 88. 71% respectively. There was no significant difference between these two groups（ P 〉0. 05）. There was no significant difference between the hematoma clearance rate,postoperative 6-month-mortality,BI,mRS,and GOS of the two groups（ P〉 0. 05）. The complication rate of early operation group and advanced operation group was 22. 88% and 25. 81% respectively. There was no significant difference between the two groups（ P 〉0. 05）. Conclusion It shows definite effect and good long function recovery of the CTSA treatment on hypertensive intracerebral hemorrhage patients,no matter it is early or late.