微创清除术治疗急性脑出血最佳手术时机研究  

Research of the best operative timing for minimal invasive puncture in the treatmemt of acute intracerebral hemorrhage

作　　者：王志艺[1] 叶宗诚[1] 陈火明[1] 王惠珍[1] 林松[1] 李志亮[1] 黄光龙[1] 王雨[1] 董飞燕[1] 

机构地区：[1]化州市人民医院神经内科,525100

出　　处：《国际医药卫生导报》2009年第24期6-10,共5页International Medicine and Health Guidance News

基　　金：2008年茂名市科研立项项目(2008261)

摘　　要：目的对颅内血肿微创清除术治疗急性脑出血最佳手术时机进行综合评价。方法将入选的急性脑出血(30～60ml)病人120例,随机分A、B、C和D组,A组病人为发病≤6小时实行微创穿刺术,B组病人为发病6～12小时之间实行微创穿刺术,C组为病人发病后12～18小时之间实行微创穿刺术,D组病人为发病后18～24小时实行微创穿刺术组,各30例。根据CT定位对患者进行YL-1型血肿穿刺引流治疗,用每例病人术前和治疗后近期远期疗效及各组术中术后再出血率、病死率、转归优良率等疗效评价指标进行组间比较。结果四组术后再出血无差异,A、B组术中再出血多、但A、B组存活者生活质量高和3个月的病死率低,明显优于C、D组(P<0.05),而A组较B组病死率低(P<0.05)。结论A组病人(≤6h)进行颅内血肿微创清除术治疗急性脑出血手术时机最佳。Objective To evaluate the best operative timing for minimal invasive puncture in the treatment of acute intracerebral hemorrhage.Metbods 120 patients with acute intracerebral hemorrhage （30～60ml） were randomly divided into four groups（A,B,C and D group,each group including 30 patients）.They were treated by YL-1 type minimal invasive puncture according to CT.The A group were treated ≤6 h from the onset of symptoms.The B group were treated within 6 - 12 h.The C group were treated within 12 ～18 h. And the D group were treated within 18 ～ 24 h.The comparison among these groups in outcome measures were performed,including the short-term efficacy,long-term efficacy,rebleeding rate,mortality,and excellent and good rate.Results The incidence of rebleeding after operation had no significantly difference between these four groups.The incidence of rebleeding in operation were higher in the A and the B groups.But the living quality in the A and the B groups were obviously higher than in the C and the D groups（p〈0.05） respectively. The mortality for 3 months in the A group was obviously lower than in the B,tbe C and the D groups（p〈0.05） respectively.Coachusiona The time within ≤6 h after the onset of acute intracerebral hemorrhage was the best operative timing for minimal invasive puncture.

关 键 词：颅内血肿微创清除术 急性脑出血 手术时机 

分 类 号：R651.12[医药卫生—外科学]