手术治疗青年高血压脑出血的临床特点分析

Surgical treatment for hypertension cerebral hemorrhage in youth:clinical features analysis

目的分析总结青年高血压脑出血临床诊疗特点,为优化其治疗方法提供依据。方法选取我院近5年收治的青年高血压脑出血40例,对其临床表现、影像学表现、发病至手术时间、手术方法及预后进行分析。结果术后1个月及术后6个月的预后良好率差异显著(P<0.05);性别、术前GCS评分、术前血肿量均未能对术后6个月预后产生影响;超早期手术(≤6 h)患者的预后更差;对于不同级别出血量的患者,采用钻孔引流术或传统开颅手术,其预后无差异(P>0.05)。结论青年高血压脑出血往往起病急、病情重、发展迅速,针对不同病例选取个体化手术方案能够优化其治疗效果。

Objective The clinical diagnostic and therapeutic features for youth hypertension cerebral hemorrhage were discussed to provide the basis for optimizing the treatment. Methods A total of 40 cases of youth hypertension cerebral hemorrhage admitted to our hospital in recent five years were selected and the clinical manifestations, imaging -ndings, operation time, operation methods and prognosis were analyzed. Results There was significant difference in good prognosis rate in post-operative 1 month and 6 months （P 〈 0. 05） ; gender, pre- operative GCS score, pre-operative hematoma volume failed to affect the prognosis of 6 months post-operatively; super early （ -〈6 h） surgery got poorer prognosis; for patients with different volume of blood loss, the drilling drainage and traditional surgical operation made no difference in prognosis （P 〉 0. 05）. Conclusion Hypertension cerebral hemorrhage in young patients may be urgent and severe and develops rapidly, so an individual operation scheme for different cases can optimize its therapeutic effect.