高血压脑出血的手术时机及术后再出血的对比分析  

Comparison Analysis of Surgical Timing and Postoperative Rebleeding of Hypertensive Intracerebral Hemorrhage

作　　者：梁旭光[1] 季明[1] 李宏岩 杜崇影 朱迪[1] 韩国祥[1] LIANG Xu-guang;JI Ming;LI Hong-yan;DU Chong-ying;ZHU Di;HAN Guo-xiang(Department of Neurosurgery,Chifeng Hospital,Chifeng,Inner Mongolia,024000 China)

机构地区：[1]内蒙古赤峰市医院神经外科

出　　处：《中外医疗》2019年第33期97-99,共3页China & Foreign Medical Treatment

摘　　要：目的分析高血压脑出血的手术时机及术后再出血的对比。方法方便选取2016年12月—2018年12月该院收治的90例高血压脑出血患者为对象。根据分组原则(不同的手术治疗时机)将90例患者分为对照组、观察1组、观察2组,每组30例。对照组发病至手术时间超过24 h,观察1组发病至手术时间在6~24 h,观察2组发病至手术时间低于6 h,对比术后再出血率、神经功能缺损程度、临床观察指标、预后效果。结果再出血率对照组3.3%、观察1组10.0%、观察2组33.3%,观察2组术后再出血率明显高于观察1组与对照组(χ2=11.335,P=0.003);血肿完全清除率对照组50.0%、观察1组83.3%、观察2组97.3%,血肿完全清除率观察1组、观察2组高于对照组(χ2=16.725,P=0.000);预后效果对照组50.0%、观察1组83.3%、观察2组76.7%,预后效果观察1组、观察2组明显高于对照组(χ2=8.889,P=0.012)。神经功能缺损评分对照组(18.2±1.6)分、观察1组(14.4±1.3)分、观察2组(13.5±1.1)分,HCY对照组(13.1±4.0)μmol/L、观察1组(11.1±2.6)μmol/L、观察2组(10.2±2.3)μmol/L,NSE对照组(13.0±3.1)ng/mL、观察1组(9.2±3.3)ng/mL、观察2组(8.5±3.4)ng/mL;BDNF对照组(2.4±0.2)ng/mL、观察1组(2.9±0.5)ng/mL、观察2组(3.1±0.5)ng/mL,神经缺损评分观察1组、观察2组明显低于对照组(P<0.05);与对照组相比,观察1组、观察2组HCY水平、NSE水平低于对照组,且BDNF明显高于对照组(P<0.05)。结论在高血压脑出血手术治疗时,最佳手术窗口期为6~24 h内,此时机实施手术治疗,可有效减轻手术缺损程度,提高血肿清除率与预后效果。Objective To analyze the timing of surgery and the recurrence of postoperative rebleeding in patients with hypertensive intracerebral hemorrhage.Methods 90 patients with hypertensive cerebral hemorrhage admitted to the hospital from December 2016 to December 2018 were conveniently selected as the subjects.According to the grouping principle(different timing of surgical treatment),90 patients were divided into control group,observation group 1 and observation group 2,30 in each group.The incidence of the control group to the operation time was more than 24 h.The incidence of the operation was from 6 to 24 hours.The incidence of the two groups was less than 6 hours.The rate of rebleeding,the degree of neurological deficit,the clinical observation index and the prognosis were compared.Results The rebleeding rate was 3.3%in the control group,10.0%in the observation group 1 and 33.3%in the observation group 2.The postoperative rebleeding rate in the observation group was significantly higher than that in the observation group 1 and the control group(χ2=11.335,P=0.003).The complete clearance rate of hematoma was 50.0%in the control group,83.3%in the observation group,and 97.3%in the observation group 2.The complete clearance rate of hematoma in the observation group 1 and the observation group 2 was higher than the control group(χ2=16.725,P=0.000).The prognostic effect was 50.0%in the control group,83.3%in the observation group and 76.7%in the observation group,and the prognostic effect in the observation group 1 and observation group 2 was significantly higher than in the control group(χ2=8.889,P=0.012).The scores of neurological defects in the control group(18.2±1.6)points,the observation group 1(14.4±1.3)points and the observa tion group 2(13.5±1.1)points were obtained. The HCY control group (13.1±4.0) μmol/L, the observation group 1(11.1±2.6) μmol/L, the observation group 2(10.2±2.3) μmol/L, the NSE control group (13.0±3.1) ng/mL, the observation group 1(9.2±3.3) ng/mL, and the observation group 2(8.5

关 键 词：高血压脑出血 手术时机 术后再出血 相关性分析 

分 类 号：R651[医药卫生—外科学]