摘要
目的 探讨高血压幕上脑出血手术方式和时机对患者预后的影响.方法 将120例高血压幕上脑出血患者按手术时机分为三组,超早期组（出血后≤6 h）40例,手术方式包括小骨窗血肿清除术22例,微创血肿穿刺引流术18例;早期组（出血后7~12 h）40例,手术方式包括小骨窗血肿清除术20例,微创血肿穿刺引流术20例;延迟组（出血后＆gt;12 h）40例,手术方式包括小骨窗血肿清除术17例,微创血肿穿刺引流术23例.评估不同手术时机和不同方式分组患者的预后及并发症,预后采用格拉斯哥评价量表（GOS）评分评定.结果 超早期组预后良好率（82.50%）高于早期组（65.0%）和延迟组（37.5%）,早期组预后良好率高于延迟组（P〈0.05）.微创血肿穿刺引流术预后良好率（65.6%）略高于小骨窗血肿清除术（57.6%）,差异未见统计学意义（P〉0.05）.超早期组并发症发生率（10.0%）低于延迟组（32.5%,P〈0.05）.微创血肿穿刺引流术并发症发生率（10.0%）明显低于小骨窗血肿清除术（32.5%,P〈0.05）.结论 高血压幕上脑出血的手术时机以超早期为佳,手术方式以微创血肿穿刺引流术更有优势,超早期个性化手术方案治疗高血压幕上脑出血,可改善疾病预后.
Objective To investigate the effect of operation mode and timing on the prognosis of patients with supratentorial hypertensive intracerebral hemorrhage.Methods A total of 120 patients with supratentorial hypertensive intracerebral hemorrhage were divided into the ultra-early group （40 cases, ≤ 6 h after bleeding）, 22 cases were treated by keyhole hematoma elimination, 18 cases were treated by minimally invasive hematoma drainage;Early group （40 cases, 7-12 h after bleeding）, 20 cases were treated by keyhole hematoma elimination, 20 cases were treated by minimally invasive hematoma drainage;Delayed group （40 cases, 〉12 h after bleeding）, 17 cases were treated by keyhole hematoma elimination, 23 cases were treated by minimally invasive hematoma drainage.The prognosis and incidence of complications in patients treated by different operation modes and at different time were evaluated, and the prognosis was evaluated by Glasgow Outcome Scale （GOS）.Results The excellent and good rate of prognosis in ultra-early group （82.50%） was higher than that in early group （65.00%） and delayed group （37.50%）, and the excellent and good rate in early group was higher than that in delay group （P〈0.05）.The excellent and good rate of prognosis after minimally invasive puncture drainage （65.6%） was higher than that after keyhole hematoma elimination （57.6%, P〉0.05）.The incidence rate of complications in ultra-early group （10.0%） was significantly lower than that in delayed group （32.50%, P〈0.05）, and the incidence rate of complications after minimally invasive puncture drainage （10.0%） was significantly lower than after keyhole hematoma elimination （32.50%, P〈0.05）.Conclusions The best timing of operation for supratentorial hypertensive intracerebral hemorrhage is ultra-early stage, and minimally invasive puncture drainage has more advantages.Ultra-early individualized operation can improve the prognosis of patients.
出处
《中国实用医刊》
2017年第15期46-48,共3页
Chinese Journal of Practical Medicine
关键词
高血压幕上脑出血
手术方式
手术时机
Supratentorial hypertensive intracerebral hemorrhage
Operation mode
Operation timing
