时效控制对有手术指征高血压脑出血患者疗效的影响研究

Effect of Time Effect Control on the Efficacy of Patients with Surgical Indications of Hypertensive Intracerebral Hemorrhage

目的探讨急性脑卒中时效控制对有手术指征的高血压脑出血患者临床预后的影响。方法回顾性分析2015年1月～2017年12月连云港市第一人民医院神经外科收治的536例入院有手术指征HICH患者的临床资料,依据建立急性脑卒中时效控制前后分组,时效控制前符合入组标准共255例,设为对照组;时效控制后,符合入组标准共281例,设为观察组。对比分析两组患者的一般资料、入院后术前时间窗和临床预后。结果两组患者性别、年龄、血压、入院时GCS评分、出血量、有无脑疝、手术方式、麻醉方式等比较,差异无统计学意义(P>0.05)。观察组患者入院后术前时间窗低于对照组[(172.17±45.14)min vs (185.26±49.34)min],差异具有统计学意义(P<0.05);观察组患者KPS评分高于对照组[(52.59±26.37)分vs (38.43±21.29)分],差异具有统计学意义(P<0.05)。结论时效控制能显著缩短入急诊室至手术开始时间,并能有效改善HICH患者手术治疗预后。

ObJective To investigate the effect of time control of acute stroke on the clinical prognosis of patients with hypertensive intracerebral hemorrhage with surgical indications. Methods A retrospective analysis of the clinical data of 536 patients with HICH admitted to the Department of Neurosurgery, Lianyungang First People＇s Hospital from January 2015 to December 2017,according to the establishment of acute cerebral apoplexy before and after the control group, 255 cases were in accordance with the admission criteria before the time limit control,and were set up as the control group.There were 281 cases in accordance with the standard of admission after time control,and they were divided into observation group.The general data,preoperative time window and clinical prognosis were compared between the two groups.Results There were no significant differences in gender,age,blood pressure,GCS score at admission,bleeding volume, presence or absence of cerebral palsy,surgical procedure,and anesthesia,the difference was not statistically significant （P〉0.05）.The preoperative time window of the observation group was lower than that of the control group [（172.17±45.14） min vs （185.26±49.34） min],the difference was statistically significant（P〈0.05）;the KPS score of the observation group was higher than that of the control group [（52.59±26.37）points vs.（38.43±21.29）points,the difference was statistically significant （P〈 0.05）.Conclusion The time effect control can significantly shorten the time from the emergency room to the start of surgery,and can effectively improve the prognosis of patients with HICH.