不同手术时机及手术方式治疗高血压性基底节区出血效果观察

Effect of different operation times and methods on hypertensive basal ganglia hemorrhage

目的 :探讨3种手术时机及2种手术方式治疗高血压性基底节区出血效果。方法 :选取高血压性基底节区出血患者215例,根据手术时机不同分为超早期组(n=70)、早期组(n=102)和延期组(n=43);根据手术方式的不同分为开颅组(n=102)和微创组(n=113)。分析所有患者术后第7天、3个月日常生活活动能力评级变化情况。结果 :超早期组术后7 d及术后3个月优良率高于早期组及延期组(P <0.05),而早期组与延期组差异均无统计学意义(P>0.05);微创组术后7 d优良率高于开颅组(P <0.05),两组术后3个月优良率差异无统计学意义(P> 0.05)。结论 :高血压性基底节区出血应用超早期治疗及微创血肿清除术治疗在第7天具有更好疗效,但3月后疗效与开颅血肿清除术相当,可根据患者实际情况选择合适的术式。

Objective:To investigate the effect of different operation times and methods on hypertensive basal ganglia hemorrhage.Methods:Two hundred and fifteen patients with hypertensive basal ganglia hemorrhage were divided into a super early group(n=70),an early group(n=102)and a delayed group(n=43)according to their operation times,and a craniotomy group(n=102)and a minimally invasive group(n=113)according to their ways of operation.The changes of activity of daily living rating of all patients at the 7th day and 3rd month after operation were analyzed.Results:The excellent rate at 7 days and 3 months after operation was higher in the super early group than the early group and delayed group(P<0.05),but there were no significant differences between early group and delayed group(P>0.05).The excellent rate was higher in the minimally invasive group than the craniotomy group(P<0.05)and however there were no significant differences between the two groups in the excellent rate at 3 months after operation(P>0.05).Conclusion:The treatment of hypertensive basal ganglia hemorrhage with super early treatment and minimally invasive hematoma removal has better curative effect on the 7th day,however the curative effect at postoperative 3 months is equivalent to that of craniotomy hematoma removal,so the appropriate operation can be selected according to the actual situation of patients.