不同手术时机软通道微创手术治疗高血压脑出血患者的临床研究

Clinical Study on the Treatment of Hypertensive Intracerebral Hemorrhage with Soft Channel Minimally Invasive Surgery at Different Operative Times

目的分析不同手术时机软通道微创手术治疗高血压脑出血患者的疗效,探讨最佳手术时期。方法对2016年9月-2018年8月期间采用软通道微创手术治疗的105例高血压脑出血患者资料进行回顾性分析。根据手术时机分为早期组(7~24小时)、延期组(24~72小时),采用格拉斯哥预后评分(GOS)和日常生活能力自理程度(ADL)分级法分别评估两组患者近期疗效和远期疗效,并比较两组患者的再出血率和死亡率。结果根据GOS评分,早期组患者的有效率为58.2%,优于延期组的38.0%,差异有统计学意义(P<0.05)。两组在再出血率和死亡率的比较上,差异无统计学意义(P>0.05)。在ADL分级的比较上,早期组的有效率为60.0%,优于延期组的37.2%,差异有统计学意义(P<0.05)。结论软通道微创手术治疗高血压脑出血的手术时机在7~24小时最佳,手术时机的选择与术后神经功能和生活自理能力的恢复程度存在密切关联。

Objective To explore the effect and the optimal operative period in Patients with hypertensive intracerebral hemorrhage(HICH)underwent soft channel minimally invasive surgery at different operative time.Methods 105 patients with hypertensive intracerebral hemorrhage treated by soft channel minimally invasive surgery from September 2016 to August 2018 were retrospectively analyzed and were divided into the early group(7-24h)and the delayed group(24-72h),according to the operation time.The short-term efficacy and long-term efficacy of the two groups were evaluated by the Glasgow Outcome Score(GOS)and the self-care degree of daily living ability(ADL),and the rate of re-bleeding and mortality of the two groups were compared.Results According to the GOS score,the effective rate of patients in the early group was 58.2%,which was higher than that in the delayed group(38.0%),and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in the rates of re-bleeding and mortality(P>0.05).In the comparison of ADL classification,the effective rate of the early group was 60.0%,which was better than that of the delayed group(37.2%),and the difference was statistically significant(P<0.05).Conclusion The optimal time of patients with HICH underwent soft channel minimally invasive surgery is from 7 to 24 hours.The choice of operation time is closely related to the recovery degree of postoperative neurological function and self-care ability.