高血压脑出血患者择时微创手术的效果分析

Analysis of the Effect of Minimally Invasive Surgery on Patients with Hypertensive Cerebral Hemorrhage

目的:探讨48 h内择时微创手术治疗高血压脑出血的临床效果。方法:选择本院住院的高血压脑出血患者60例,其中符合24 h内微创手术的患者作为对照组29例,31例观察组48 h内择时实施微创手术。采用日常生活ADL分级、格拉斯哥预后评分(GOS)、术后并发症、临床疗效评价两组微创手术的效果。结果:治疗后,观察组Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ级及死亡病例数,GOS评分优、良、中、差,并发症发生情况,总有效与对照组比较,差异均无统计学意义(P>0.05)。结论:高血压脑出血患者通过有效的止血、脱水降颅压、抗感染、控制血压、改善脑循环、降温、纠正水、电解质紊乱、补充能量、保护神经的治疗,在48 h内实施微创手术,其效果与24 h内实施微创手术的效果相当,这为高血压脑出血患者手术的时间窗提供了新的见解。

Objective： To investigate clinical effect of minimally invasive surgical for patients with hypertensive intracerebral hemorrhage within 48 hours.Method： 60 patients with cerebral hemorrhage in our hospital were divided into 29 cases of minimally invasive surgery within 24 hours as the control group, 31 cases of choose minimally invasive surgery within 48 hours in the observation group.Used ADL classification of daily life, Glasgow Prognostic Score （ GOS ）, postoperative complications, clinical efficacy evaluation of minimally invasive surgery in the two groups.Result： After treatment, Ⅰ、Ⅱ、Ⅲ、Ⅳ and Ⅴ levels of daily life ADL grading and number of deaths, excellent, good, middle and poor score results of GOS score, complications, clinical effect in the observation group were not statistically difference compared with the control group（ P〉0.05 ）. Conclusion： Patients through effective hemostasis of hypertensive cerebral hemorrhage, dehydration reducing intracranial pressure, anti infection, control blood pressure, improve cerebral circulation, cooling, correct water, electrolyte disturbance, energy, neuronprotective therapy, minimally invasive surgery within 48 h, and the effect is 24 h in the implementation of minimally invasive surgery, which provides new insights into the time window operation in patients with hypertensive cerebral hemorrhage.