不同手术时机对高血压脑出血患者神经功能及预后的影响

Effects of Different Operation Timing on Neurological Function and Prognosis of Patients with Hypertensive Cerebral Hemorrhage

目的探讨不同手术时机对高血压脑出血患者术后神经功能情况及预后的影响。方法将我院收治的152例老年急性脑梗患者作为研究对象,依据手术时机不同分为超早期手术组67例和早期手术组85例。比较两组患者术后发生再出血、神经功能情况。结果超早期手术组再出血发生率和神经功能格拉斯哥昏迷评分(GCS)均高于早期组(P均<0.05),超早期近期手术组疗效不良发生率(23.88%)高于早期手术组(10.59%)(P<0.05),术后6个月超早期手术组和早期手术组患者预后良好发生率和预后不良发生率差异均无统计学意义(P均>0.05)。结论对高血压脑出血患者应综合考虑超早期与早期手术的风险与收益,6~24 h手术是较为安全和有效的时间窗。

Objective To investigate the effect of different operation timing on postoperative neurological function and prognosis of patients with hypertensive intracerebral hemorrhage.Methods A total of 152 elderly patients with acute cerebral infarction treated in our hospital were divided into ultra-early operation group(n=67)and early operation group(n=85)according to the timing of operation.The differences of postoperative rebleeding and neurological function between the two groups were compared.Results The incidence of rebleeding and the GCS score of neurological function in the ultra-early operation group were higher than those in the early operation group(P all<0.05).The incidence of poor curative effect in the ultra-early operation group(23.88%)was higher than that in the early operation group(10.59%)(P<0.05).Six months after operation,there was no significant difference in the incidence of good prognosis and poor prognosis between the ultra-early operation group and the early operation group(P all>0.05).Conclusion The risks and benefits of ultra-early and early operation should be comprehensively considered for patients with hypertensive intracerebral hemorrhage.The 6-24 hours operation is a safe and effective time window.