老年高血压脑出血患者超早期手术治疗的临床疗效  

Effect of Ultra Early Surgical Treatment on Cerebral Hemorrhage in Elderly Patients with Hypertensive Cerebral Hemorrhage

作　　者：胡振宇[1] 雍成明[1] 宣家龙[1] 

机构地区：[1]安徽医科大学附属巢湖医院神经外科,安徽巢湖238000

出　　处：《医学综述》2017年第5期1030-1033,共4页Medical Recapitulate

摘　　要：目的探讨老年高血压脑出血患者超早期手术治疗的临床疗效。方法选择2013年6月至2015年6月安徽医科大学附属巢湖医院收治的68例老年高血压脑出血患者为研究对象,根据不同手术时间分为早期组(发病至手术时间6~24 h,n=37)和超早期组(发病至手术时间<6 h,n=31)。两组患者均行微创颅内血肿清除术治疗,比较两组患者的临床疗效及日常生活能力和运动能力。结果治疗3周后,超早期组整体临床疗效显著高于早期组(Z=2.034,P<0.05);治疗1个月后,超早期组意识恢复率及致残率分别为90.3%(28/31)和12.9%(4/31),均显著优于早期组[70.3%(26/37),35.1%(13/37)](P<0.05);治疗后3个月,超早期组Barthel指数法、Fugl-Meyer运动功能评分法评分分别为(74±7)分和(69±12)分,均显著高于早期组[(69±5)分和(63±10)分](P<0.05);超早期组并发症发生率为22.6%(7/31),与早期组的32.4%(12/37)比较差异无统计学意义(P>0.05)。结论老年高血压脑出血患者超早期手术治疗明显提高了临床疗效,并改善了患者近期日常生活能力及运动能力,且未增加患者并发症发生率,但要注意监测患者再次脑出血的发生。Objective To investigate the effect of ultra-early surgical treatment on cerebral hemorrhage in elderly patients. Methods A total of 68 cases of elderly hypertensive cerebral hemorrhage in Chaohu Hospital Affiliated to Anhui Medical University from Jun. 2013 to Jun. 2015 were included in the study, according to the different operation time they were divided into an early group （6-24 h between onset and surgery,n = 37） and an ultra-early group（ 〈 6 h between onset and surgery, n = 31 ）. All patients were treated with minimally invasive intracranial hematoma. The clinical efficacy, daily life ability and exercise capacity were compared between the two groups. Results After 3 weeks of treatment, the overall clini- cal efficacy in the ultra-early group was significandy higher than the early group （ Z = 2. 034, P 〈 0.05 ） ; 1 month after treat- ment,the recovery rate and disability rate in the ultra-early group were 90. 3% （28/31） and 12. 9% （4/31） ,which were significantly better than 70. 3% （26/37） ,35. 1% （13/37） in the early group（P 〈0. 05） ;3 months after treatment,the BI scores and FMA scores in the ultra-early group were （74 ± 7 ） scores and （69 ± 12） scores ,which were significantly higher than （69±5） scores and （63 ± 10） scores in the early group（P 〈0. 05） ;the incidence of complications in the ultra-early group was 22. 6% （7/31）, in the early group was 32. 4% （ 12/37 ）, the difference was not statistically significant （ P 〉 O. 05）. Conclusion The uhra-early surgery can significantly improve the clinical efficacy and improve the recent activity of daily living and exercise capacity in treating elderly hypertensive patients with cerebral hemorrhage without increasing the complication incidence, though careful monitoring of the patients should be done to prevent recurrent cerebral hemorrhage.

关 键 词：高血压脑出血 老年患者 手术时间 超早期手术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]