手术时机对重症高血压脑出血治疗效果的价值研究

Study on the Value of Operation Timing in the Treatment of Severe Hypertensive Intracerebral Hemorrhage

目的观察分析重症高血压脑出血患者在不同时机进行微创血肿穿刺引流手术治疗的临床效果,为临床有效救治重症高血压脑出血患者提供指导,达到挽救患者性命、使其生存质量与预后显著改善的目的。方法于2020年5月至2021年5月,将本院纳入的94例重症高血压脑出血患者作为课题对象,根据不同手术治疗时机,将之分组干预,即患者发病到入院手术时间<7 h作为研究组,患者发病到入院手术时间≥7 h为常规组,手术方式均为微创血肿穿刺引流术。每组47例患者。利用统计学软件SPSS 22.0对比分析研究组与常规组手术治疗效果、术后并发症、GCS意识功能评分、Barthel指数、FMA评分、NIHSS神经功能缺损评分、生存质量。结果研究组总体疗效高于常规组(P<0.05);研究组术后并发症发生率低于常规组(P<0.05);研究组GCS评分、Barthel指数、FMA评分高于常规组,NIHSS评分低于常规组(P<0.05);研究组术后生存质量评分高于常规组(P<0.05)。结论重症高血压脑出血患者发病后7 h内尽快入院接受手术治疗,能够进一步减少相关并发症的发生,改善其神经功能与生存质量,促使其意识早日恢复,提高其日常生活能力及肢体运动功能,手术疗效显著。

Objective To observe and analyze the clinical effect of minimally invasive hematoma puncture and drainage in patients with severe hypertensive intracerebral hemorrhage at different times,so as to provide guidance for clinical effective treatment of patients with severe hypertensive intracerebral hemorrhage,so as to save patients'lives,improve their quality of life and prognosis.Methods From May 2020 to May 2021,94 patients with severe hypertensive intracerebral hemorrhage in our hospital were selected as the research objects,and they were divided into two groups according to different surgical treatment time,namely,patients with operation time<7 h from onset to admission were selected as the research group,patients with operation time≥7 h from onset to admission were selected as the conventional group,and the operation method was minimally invasive hematoma puncture and drainage.Forty-seven patients in each group.SPSS22.0 was used to compare the surgical treatment effect,postoperative complications,GCS consciousness function score,Barthel index,FMA score,NIHSS nerve function defect score and quality of life between the two groups.Results The effect of surgical treatment in the research group was significantly higher than that in the conventional group(P<0.05);The incidence of postoperative complications in the research group was lower than that in the conventional group(P<0.05);The GCS score,Barthel Index and FMA score of the research group were higher than those of the conventional group,while the NIHSS score of the research group was lower than that of the conventional group(P<0.05);The postoperative quality of life score of the research group was higher than that of the conventional group(P<0.05).Conclusions Patients with severe hypertensive intracerebral hemorrhage were admitted to hospital for surgical treatment as soon as possible within 7 hours after onset,which can further reduce the occurrence of related complications,improve their neurological function and quality of life,promote their consciousness to recover as soon as possible,improve their ability of daily living and limb motor function.