微创穿刺术治疗高血压脑出血的手术时机选择

Surgical timing of minimally invasive puncture for hypertensive intracerebral hemorrhage

目的探讨微创穿刺术治疗高血压脑出血(HICH)的最佳时间窗口。方法回顾性分析2013-10—2019-10信阳市中心医院收治的287例HICH患者的临床资料,将发病至手术时间<6 h的患者纳入A组,将发病至手术时间6~24 h的患者纳入B组,将发病至手术时间>24 h的患者纳入C组。对比各组近期疗效、远期疗效及术后并发症发生情况。结果A组和C组及B组和C组近期疗效优良率比较(73.86%vs 67.69%,83.58%vs 67.69%),差异均有统计学意义(P<0.05)。A组术后再出血发生率12.50%,远高于B组(5.22%)和C组(3.08%),差异有统计学意义(P<0.05)。A组患者远期疗效优良率高于B组和C组(70.45%vs 53.73%,55.38%),差异有统计学意义(P<0.05)。结论高血压脑出血后6~24 h行微创穿刺术对于符合条件的患者是更为理想的手术时间窗。

Objective To explore the best time window for minimally invasive puncture in the treatment of hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 287 HICH patients treated in our hospital from October 2015 to October 2019 were retrospectively analyzed.Will be the incidence of surgery to less than 6 h called A group,the incidence of surgery to 6-24 h called B group,the incidence of surgery to more than 24 h called C group.The short-term efficacy of each group,long-term efficacy and postoperative complications were compared.Results The excellent and good rates of group A and group C and group B and group C were(73.86% vs 67.69%,83.58% vs 67.69%),the difference was significant(P<0.05).The incidence of postoperative rebleeding in group A was 12.50%,which was significantly higher than that in group B(5.22%) and group C(3.08%)(P<0.05).The excellent rate of long-term efficacy of group A was significantly higher than that of group B and group C(70.45% vs 53.73% and 55.38%),the difference was significant(P<0.05).Conclusion Minimally invasive puncture after 6-24 h of hypertensive intracerebral hemorrhage is an ideal operation time window for eligible patients.