不同手术时机治疗高血压脑出血的对比分析研究

Comparative analysis of different surgical timing for hypertensive intracerebral hemorrhage

目的对比分析研究不同手术时机治疗高血压脑出血的临床效果。方法选取60例高血压脑出血患者,按照手术时机的不同分为超早期组(出血后7 h内实施手术)、早期组(出血后8~24 h内实施手术)和延迟组(出血后24~48 h实施手术)3组,各20例,均行颅内血肿微创清除术,观察比较3组患者手术治疗的效果、预后情况、术后并发症发生情况及再出血情况。结果超早期组治疗的优良率明显高于早期组和延迟组,预后良好率明显高于早期组和延迟组,术后各并发症发生率明显低于早期组和延迟组,再出血率明显高于早期组和延迟组,差异具有统计学意义(P<0.05)。结论高血压脑出血患者行超早期和早期手术的效果优于延期手术的效果,术后并发症少,可有效改善患者预后,降低死亡率,但应注意超早期手术后再出血的风险较高,应根据患者具体情况选择适当的手术时机。

Objective To compare and analyze the clinical effects of different surgical timing on hypertensive intracerebral hemorrhage.Methods Treated60cases of patients with hypertensive cerebral hemorrhage,according to the different timing of surgery for ultra early group(7h surgery bleeding),early group(ICH8-24h surgery group)and delayed group(bleeding after24-48h surgery group),20patients in each group underwent minimally invasive removal of intracranial hematoma,and rebleeding complications of patients with surgical treatment were compared between the3groups to observe the effect,prognosis,postoperative.Results The excellent rate of ultra early group treatment was significantly higher than that of early and delayed groups,good prognosis rate was significantly higher than that of early and delayed groups,the incidence of postoperative complications was significantly lower than that in the early group and delayed group,the rate of rebleeding was significantly higher than that in the early group and delayed group(P<0.05),the difference has statistical significance.Conclusion Patients with ultra early and early surgery is better than delayed surgery for hypertensive cerebral hemorrhage,less postoperative complications,patients can effectively improve prognosis,reduce mortality,but should pay attention to the higher risk of rebleeding after ultra early surgery,should choose the proper operation time according to the specific circumstances of patients.