超早期与早期血肿穿刺引流术对高血压脑出血患者的影响

Influence of Ultra-early and Early Hematoma Puncture and Drainage Surgery on Patients with Hypertensive Cerebral Hemorrhage

目的:探究超早期与早期血肿穿刺引流术对高血压脑出血患者的影响。方法:回顾性分析2019年1月—2022年12月无锡市惠山区人民医院收治的102例高血压脑出血患者的临床资料。根据手术时间的不同将其分为常规组和试验组,各51例。常规组发病6~12 h进行血肿穿刺引流术;试验组发病<6 h行血肿穿刺引流术。比较两组围手术期指标,术前、术后2 d、4 d、6 d神经功能,术前、术后2个月日常生活能力,并发症及预后情况。结果:试验组手术时间短于常规组,术中出血量少于常规组,差异有统计学意义(P<0.05)。术后2 d、4 d、6 d,试验组中国脑卒中患者临床神经功能缺损程度评分量表(CSS)评分低于常规组,差异有统计学意义(P<0.05)。术后2个月,两组日常生活能力评分提高,试验组日常生活能力评分高于常规组,差异有统计学意义(P<0.05)。试验组并发症发生率低于常规组,差异有统计学意义(P<0.05)。术后3个月,试验组预后情况优于常规组,差异有统计学意义(P<0.05)。结论:超早期血肿穿刺引流术治疗高血压脑出血患者,有利于促进神经功能恢复,改善日常生活能力,改善患者的预后。

Objective:To explore the influence of ultra-early and early hematoma puncture and drainage surgery on patients with hypertensive cerebral hemorrhage.Method:The clinical data of 102 patients with hypertensive cerebral hemorrhage admitted to Huishan District People's Hospital of Wuxi from January 2019 to December 2022 were retrospectively analyzed.According to the different operation time,the patients were divided into conventional group and experimental group,51 cases in each group.In the conventional group,hematoma puncture and drainage surgery were performed 6-12 h after onset.Hematoma puncture and drainage surgery were performed in experimental group<6 h after onset.Perioperative indexes,neurological function before surgery,2 d,4 d and 6 d after surgery,daily living ability before surgery and 2 months after surgery,complications and prognosis condition were compared between the two groups.Result:The surgery time of experimental group was shorter than that of conventional group,and the intraoperative blood loss volume was less than that of conventional group,the differences were statistically significant(P<0.05).At 2 d,4 d and 6 d after surgery,China stroke clinical neurological function deficit scale(CSS)scores of experimental group were lower than those of conventional group,and the differences were statistically significant(P<0.05).Two months after surgery,the daily living ability scores of the two groups were increased,and the daily living ability score of the experimental group was higher than that of the conventional group,and the differences were statistically significant(P<0.05).The incidence of complication of experimental group was lower than that of conventional group,and the difference was statistically significant(P<0.05).Three months after surgery,the prognosis condition of experimental group was better than that of conventional group,and the difference was statistically significant(P<0.05).Conclusion:The treatment of patients with hypertensive intracerebral hemorrhage with ultra-early hematoma puncture and drainage surgery is beneficial to promote the recovery of nerve function,improve the ability of daily living,and improve the prognosis of patients.