高血压脑出血手术治疗时间的选择及疗效差异比较  

Comparison of the Choice of Surgical Treatment Time for Hypertensive Intracerebral Hemorrhage and the Difference of Curative Effect

作　　者：李志强[1] 朱振云[1] 梁建锋[1] 李剑 LI Zhiqiang;ZHU Zhenyun;LIANG Jianfeng;LI Jian(Department of Neurosurgery, The First Hospital of Fangshan District of Beijing, Beijing 102400, China)

机构地区：[1]北京市房山区第一医院神经外科,北京102400

出　　处：《中国继续医学教育》2018年第14期118-120,共3页China Continuing Medical Education

摘　　要：目的探讨高血压脑出血手术治疗时间的选择及疗效差异。方法选取116名高血压脑出血(CT确诊)手术患者作为研究对象,以手术治疗时间为视角,划分成非早期组、早期组、超早期组。研究中主涉及三种血肿清除术:开颅血肿清除术、小骨窗开颅血肿清除术、微创血肿穿刺清除术。结果超早期手术组术后疗效高于早期组和非早期组,而早期组又高于非早期组。开颅组术后并发症与再出血发生率高于小骨窗手术组和微创组,而小骨窗手术组又高于微创组。超早期组预后状况高于早期组和非早期组,而早期组又高于非早期组。结论高血压脑出血手术治疗时间及方式选择,直接影响手术患者治疗疗效及预后情况,而选择手术时间≤6 h的超早期治疗,能够有效改善患者预后,减少再出血的发生率,提升患者的生存率与降低致残率。Objective To explore the choice of operation time and the diference of curative efect in hypertensive intracerebral hemorrhage. Methods 116 patients with hypertensive intracerebral hemorrhage （CT） were selected as the research objects. From the perspective of operative time, they were divided into non early group, early group and super early group. Three kinds of hematoma removal were involved in the study： craniotomy and hematoma clearance, small bone window craniotomy and hematoma clearance, and minimally invasive hematoma puncture clearance. Results The curative effect of the super early operation group was signifcantly higher than that in the early group and the non early group, but the early group was higher than the non early group. The incidence of postoperative complications and rebleeding in the craniotomy group was signifcantly higher than that in the small bone window operation group and the minimally invasive group, while the small bone window hand was higher than the minimally invasive group. The prognosis of the super early group was signifcantly higher than that in the early group and the non early group, but the early group was higher than that in the non early group. Conclusion The surgical treatment of hypertensive cerebral hemorrhage and time, directly afect the therapeutic efect and prognosis of patients with surgical treatment, and the choice of ultra early surgery time less than 6 h, can efectively improve the prognosis, reduce the incidence of rebleeding, improve patient survival rate and disability rate.

关 键 词：高血压 脑出血 手术治疗时间 选择 疗效差异 神经外科 

分 类 号：R651[医药卫生—外科学]