重症高血压脑出血患者手术时机和手术方式与疗效的关系研究

The relationship between the timing of operation and the mode of operation and the curative effect in patients with severe hypertensive intracerebral hemorrhage

目的:探究不同手术时机与手术方式对高血压脑出血患者的治疗效果。方法:选取118例重症高血压脑出血患者,根据发病到手术时间分为三组。甲组出血后7 h内进行手术治疗,乙组出血后8~24 h内进行手术治疗,丙组出血后超过24 h进行手术治疗。对三组患者术后预后情况予以对比。结果:甲组预后1级、2级比例比乙组高,5级比乙组低,差异有统计学意义(P<0.05);甲组、乙组患者死亡率、3级、4级比例比较,差异无统计学意义(P>0.05);甲组1级、2级、3级比例高于丙组,且甲组4级、5级比例与死亡率比丙组低,差异有统计学意义(P<0.05)。乙组1级、2级、3级比例比丙组高,4级与死亡率比丙组低,差异有统计学意义(P<0.05)。乙组与丙组5级比例无统计学意义(P>0.05)。结论:重症高血压脑出血患者进行超早期或早期手术治疗,可降低患者的致残率与死亡率,并根据出血量、出血部位与特点合理选择手术方式,可使患者的预后情况充分改善。

Objective To explore the different timing of surgery and the surgical approach for the treatment of patients with hypertensive cerebral hemorrhage.Method118cases of severe hypertensive cerebral hemorrhage patients were selected,according to the time from onset to surgery,they were divided into three groups,group A:7hours after the surgery for the treatment of bleeding in surgery,bleeding after8~24in group B within hours,group C:bleeding more than24hours after surgery.The prognosis were compared between three groups of patients.Results The prognosis of1grade,2grade proportion of group B high grade5than group B,with statistical significance(P<0.05);group A and Group B,the mortality of patients,grade3,grade4of the proportion of comparison was not statistically significant(P>0.05);group a level1,level2,level3was higher than that of group C,group A and4grade,5grade proportion and low death rate than group C,there was statistical significance(P<0.05).In group B,1,23,the proportion of group C high level4,and low mortality rate than group C,there was statistical significance(P<0.05).Compared with group B and group C5grade ratio was not statistically significant(P>0.05).Conclusion Ultra early or early surgical treatment of patients with severe hypertensive cerebral hemorrhage,can reduce patient morbidity and mortality,and according to the amount of bleeding,the bleeding The reasonable choice of operation mode can improve the prognosis of the patients