高血压脑出血微创手术治疗的最佳时间窗研究  

Optimal time window for minimally invasive surgery on hypertensive cerebral hemorrhage

作　　者：王上桥 梁定兴 蒲坚[1] 李多[1] 李猛[1] 

机构地区：[1]海南省儋州市第一人民医院外三科,海南儋州571700

出　　处：《西南国防医药》2012年第7期720-722,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的研究高血压脑出血微创手术治疗的最佳时间窗。方法入选123例高血压脑出血患者,分为超早期组(n=41)、早期组(n=38)以及延期组(n=44),均采用CT指引行微创穿刺术。治疗后比较分析上述3组患者的相关临床资料。结果术后2 w,3组患者的SSS评分无统计学差异(P>0.05);术后3个月,超早期组的MRS评分较其他两组明显改善(P<0.05)。术后3个月,超早期组的重度残疾率较其他两组明显减少(P<0.05),无功能障碍患者比例也较其他两组明显增多(P<0.05)。结论出血后7 h内是高血压脑出血微创手术治疗的最佳时机,在此期内及时进行手术治疗,可以显著改善患者的远期预后。Objective To investigate the optimal time window for minimally invasive surgery on hypertensive cerebral hemorrhage. Methods 123 patients with hypertensive cerebral hemorrhage were selected and divided into three groups：ultra - early period group（n = 41 ）, early period group （ n = 38 ）, and delayed group （ n = 44 ）. All of them received the minimally invasive paracentesis guided by CT. After the treatment, the clinical data of the three groups were compared and analyzed. Results Two weeks after the operation, there was no significant difference in SSS scores among the three groups （ P 〉 0.05 ）. Three months after the operation, compared with the MRS scores of the other two groups, those of the ultra - early period group were significantly improved （ P 〈 0.05）. And compared with the data of the other two groups, the severe disability rate of the ultra - early period group significantly decreased（ P 〈 0.05 ）, and the ratio of patients without dysfunction significantly increased （ P 〈 0.05 ）. Conclusion The optimal time of minimally invasive surgery for patients with hypertensive cerebral hemorrhage is within 7 h after the hemorrhage. And the surgery within the optimal time can significantly improve the patients＇long - term prognosis.

关 键 词：高血压脑出血 微创手术 时间窗 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]