摘要
目的研究高血压脑出血最佳手术时机。方法500例高血压性脑出血,内科组234例,外科组266例。按发病-治疗时间分为:①≤7h,②7～24h,③>24h3组,分别进行内、外科疗效比较和组间外科疗效比较。疗效判定指标为:近期疗效、远期疗效、病死率、优良率和并发症发生率等。结果①发病-治疗时间≤24h组:手术疗效优于内科治疗;②发病-治疗时间≤7h和7～24h组:手术疗效无显著差异;③发病-治疗时间≤7h组:术后颅内再出血风险高,超过7h后再出血率下降;④发病-治疗时间>24h组,外科组的呼吸、泌尿和消化系统并发症发生率高于内科组。结论发病后7～24h内,是最佳手术时机。
Objective To determine the optimal time course for surgical treatment of hypertensive intracerebral hemorrhage. Methods Among all 500 cases of ICH, th ere were 234 cases for medical treatment and 266 cases for surgical treatment. A ccording to the time course after initial onset, they were divided into three gr oups, which were Ultra-early group (≤ 7 h),Early group (7～24 h), and Delay gro up (> 24 h). The near-term outcome (GOS scale), long-term outcome (Barthel scale ), mortality, as well as incidence of associated complications were compared res pectively. Results ①In the Ultra-early and Early groups,both the near-term and long-term outcome of surgical treatment was definitely better than medical treat ment.②For the outcome of surgical treatment, there was no significantly differe nce between Ultra-early and Early groups.③In the Ultra-early group, the risk of recurrent post-operative hemorrhage was higher, and decreased henceforth.④In t he Delay group, the incidence of associated complications of respiratory, urinar y and gastrointestinal system was higher for surgery than medication. Conclusion The early stage (7～24 h) was the optimal time course for surgical treatment of intracerebral hemorrhage.
出处
《中国微侵袭神经外科杂志》
CAS
2003年第1期21-24,共4页
Chinese Journal of Minimally Invasive Neurosurgery
基金
上海市卫生局医药重点发展基金(982D002)
