不同方式治疗自发性脑出血患者的生存情况对比研究  

Comparative study of survival situation of patients with cerebral hemorrhage after different treatment modalities

作　　者：宁书增[1] 王雷波[1] 

机构地区：[1]天津市海河医院脑系科,天津市300350

出　　处：《国际神经病学神经外科学杂志》2012年第1期12-15,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨不同治疗方式对自发性脑出血(Spontaneous intracerebral hemorrhage,SICH)患者生存期和生存质量的影响;方法回顾性总结我院SICH患者共计320例,严格限定入选标准,按照GCS评分情况,将其分为GCS≤8分、GCS 9～12分和GCS≥13分三个组别,并对每个组别不同治疗方式的患者生存期和生存质量进行评估,应用Cox回归分析,以P≤0.05为具有统计学意义;结果在生存期和生存质量方面,不同治疗方式存在明显的差异,GCS≤8分组患者生存质量和生存期限明显差于另外两组,而在同组中,不同的治疗方式亦会导致生存期和生存质量的差异,以立体定向血肿碎吸对患者生存质量提高明显(在三个组别中,预后良好率分别达到53%、72%、79%)与另外几种治疗方式相比具有统计学意义(P≤0.05),而开颅手术则明显提高患者生存率(GCS≤8分和GCS 9～12分组生存期超过18个月的分别达到41%和55%)而且与另外几种治疗方式相比具有统计学差异(P≤0.05)。结论对SICH患者施以恰当及时的外科干预,可进一步提高患者生存期及生存质量。Objective To study impact of the different treatment modalities on patient survival and quality of life of patients with spon- taneous cerebral hemorrhage. Methods Total of 320 cases of SICH patients were reviewed, and divided into GCS ≤ 8, GCS9-12 and GCS ≥ 13 three groups according to GCS score. For each group of different treatment modalities of patient survival and quality of life was assessed, and the data was analysized with Cox regression . P≤0.05 for statistical significance. Results The quality of life and survival duration in group GCS ≤8 were significantly worse than that in the other two groups. As well different treatment modalities would lead to the differences in the quality of life and survival duration in the same group. Survival quality improved obviously（ good prognosis rate achieved 53%, 72% and 79% respectively） in the patients underwent stereotactic hematoma aspiration, compared to the other groups（ P ≤ 0.05 ）. Whereas the survival rate improved obviously （Survival period over 18 months at groups GCS ≤ 8 and GCS9-12 reached 41% and 55% respectively） in the patients underwent craniotomy operation. （P≤0.05）. Conclusions It may further improve the patients survival and quality of life of SICH when treated with appropriate and timely surgical intervention.

关 键 词：脑出血 治疗方式 生存期 生存质量 

分 类 号：R743.3[医药卫生—神经病学与精神病学]