不同时期软通道技术治疗急重症高血压脑出血的疗效和预后评价

The curative effect of treatment on severe hypertensive cerebral hemorrhage in different periods with soft channel technology and prognosis evaluation

目的探讨不同时期软通道技术治疗急重症高血压脑出血的临床效果和预后生活质量。方法对89例重症高血压脑出血患者的临床资料回顾性分析,所有患者均采用软通道技术治疗。其中23例患者在发病后6 h内手术(早期组),34例患者在发病后6~24 h内手术(中期组),其余32例患者在发病后24~72 h内手术(晚期组)。使用头颅计算机断层扫描(CT)测量血肿大小,血肿清除率,治愈率,并发症以及术后1个月及6个月随访对日常生活质量评定量表(ADL)进行评定,比较不同时期的疗效和近期及远期预后生活质量。结果在软通道技术治疗后,早期治疗组患者的术后5天血肿量以及血肿清除率及并发症显著低于中期组和晚期组;治疗1个月和6个月后ADL评定为Ⅰ~Ⅲ级的患者比例,早期组患者显著高于中期组,中期组患者高于晚期组。结论早期软通道技术治疗高血压脑出血不仅具有较好的疗效,而且能够减少并发症,改善患者生活质量,提高患者近期和远期预后。

Objective To explore the curative effect of different periods treatment of severe hypertensive cerebral hemorrhage with soft channel technology and prognosis evaluation of quality of life. Methods The clinical data of 89 severe hypertensive cerebral hemorrhage patients were retrospectively analyzed,all patients were performed with the soft channel technology treatment.23 patients are performed with surgery within 6 h after the onset（ the early group）,34 patients are performed with surgery within 6 ~ 24 h after the onset（ the middle group）,the rest of the 32 patients are performed with surgery within 24 ~ 72 h after onset（ the late group）. Coronal CT is used to measure the hematoma size. Cure rates,complications and 1 month and 6 months postoperative follow-up rating scale to the quality of daily life（ ADL） were assessed to compare different period of efficacy and long-term prognosis and quality of life in the near future. Results The hematoma volume after surgery for five days in the early group was statistically significantly higher than that observed in the middle group and the late group,respectively.The complication rate in the early group was also statistically lower than that observed in the middle group and late group.After cure for 1 month and 6 month,the proportion of patients classified as Ⅰ ~ Ⅲ based on ADL in the early group were statistically significantly higher than that observed in the middle group,and the proportion of patients in the Ⅰ ~ Ⅲ in the middle group was statistically significantly higher than that in the late group. Conclusion Early soft channel technology treatment of hypertensive cerebral hemorrhage not only has more curative effect,but also can significantly reduce complications and improve self-care ability and life quality in the near future and long-term prognosis.