重症高血压脑出血患者手术时机对预后的影响

Effect of timing of surgery on prognosis of severe hypertensive cerebral hemorrhage

目的探讨重症高血压脑出血患者手术时机对预后的影响。方法回顾性分析118例重症高血压脑出血患者的临床资料,根据患者从发病到手术时间进行分组。A组43例发病至手术时间≤7 h,B组38例发病至手术时间7~24 h,C组37例发病后24 h手术。比较各组临床疗效。结果 A组患者ADLⅠ级的比例最高25.6%,其次为B组13.2%,C组比例5.4%最低(P<0.05);A组Ⅴ级及死亡比例最低4.7%、7.0%,显著低于C组(P<0.05)。Ⅰ级和Ⅱ级患者中,A组23例,占53.5%,B组11例,占28.9%,C组6例,占16.2%,三组间比较差异有统计学意义(P<0.05)。结论重症高血压脑出血患者在可能的情况下,应尽早行手术治疗。

Objective To discuss effect of timing of surgery on prognosis of severe hypertensive cerebral hemorrhage.Methods Clinical data of 118 cases with severe hypertensive cerebral hemorrhage were divided into three groups according to the time from the onset to surgery. Onset to operation of group A was ≤7 h, a total of 43 cases; Group B was7-24 h, a total of 38 cases; And a total of 37 cases in group C were >24 h. Clinical efficacy of three groups were compared. Results Group A had the highest level ADLⅠ proportion of 25.6%, next was group B with 13.2%, and group C was lowest with 5.4%(P<0.05); Group A Ⅴ grade and deaths proportion were lowest(4.7% and 7.0%), which were lower than group C(P<0.05). Patients with stageⅠ and Ⅱ of group A were 23 cases, accounting for 53.5%, Group B were11 cases, accounting for 28.9%, and group C were 6 cases, accounting for 16.2%, which showed significant difference(P<0.05). Conclusion Hypertensive encephalopathy disease patients should be treated surgically as soon as possible.