不同时机行小骨窗显微手术治疗高血压脑出血的疗效对比  

Comparative analysis on the effect of different timing of microsurgery through small skull window in the Treatment for Hypertensive Intracerebral Hemorrhage

作　　者：侯红武[1] 胡世颉[2] 周跃飞[2] 田龙飞[1] 王伟[1] 

机构地区：[1]西安华山中心医院外一科,陕西西安710000 [2]第四军医大学西京医院神经外科,陕西西安710000

出　　处：《医药前沿》2017年第24期9-11,共3页Journal of Frontiers of Medicine

摘　　要：目的：分析小骨窗显微手术治疗高血压脑出血的最佳手术时机。方法：选择我院神经外科收治的需行小骨窗显微手术治疗的高血压脑出血患者99例，根据患者病发至手术时间间隔的长短分为超早期组（6h内）、早期组（6～24h）和晚期组（24h以上），三组患者均行小骨窗显微手术治疗，比较三组患者的存活率、并发症发生率、近期疗效和远期疗效。结果：超早期组患者的存活率显著高于其他两组，而坠积性肺炎、泌尿系统感染、应激性溃疡及高血糖等并发症的发生率显著低于其他两组，差异均有统计学意义（P〈0．05）；超早期组患者死亡和植物生存的发生率显著少于其他两组，而恢复良好和轻度残疾的发生率显著高于其他两组，差异有统计学意义（P〈0．05）；超早期组患者恢复至I级和Ⅱ级的例数显著高于其他两组，而恢复至IV级和V级的人数显著低于其他两组，差异均有统计学意义（P〈0．05）；结论：超早期（发病后6h内）是行小骨窗显微手术治疗高血压脑出血的最佳时机。Objective To optimize the optimal timing of microsurgery through small skull window for the treatment of hypertensive intracerebral hemorrhage. Method 99 cases HICH patients were selected as object of study, and according to the length of the disease with operation time interval was divided into super early group （6 h） and early group （6~24 h） and late group（more than 24 h）. Three groups of patients were treated by small bone window microsurgery treatment, than comparison the survival rate, complications, recent curative effect and long-term effect of three group patients. Results Survival rate of super early group was significantly higher than other two groups, but the hypostatic pneumonia, urinary tract infections, stress ulcer, incidence of complications and high blood glucose were significantly lower than the other two groups, difference had statistical significance （P〈0.05）; The death and plant survival rate, but the incidence of recovered well and mild disabilities of super early group was significantly higher than other two groups, the difference was statistically significant （P〈0.05）; Super early group patients returned to I level and I[ level were significantly higher than the other two groups, and returned to IV level and V level were significantly lower than the other two groups, the differences had statistical significance（P〈0.05）. Conclusion Super early （within 6 h after onset） is the best time for the treatment of hypertensive cerebral hemorrhage.

关 键 词：手术时机 小骨窗显微手术 高血压脑出血 疗效 

分 类 号：R743.2[医药卫生—神经病学与精神病学]