不同手术时机对高血压脑出血(HICH)患者术后再出血及近期疗效的影响分析  

Effect of Different Operation Time on Postoperative Rebleeding and Recent Curative Effect of Hypertensive Cerebral Hemorrhage

作　　者：沈冠豪[1] 李奕秋 华春华 朱道平[1] 卢智[1] 李怀国 SHEN Guanhao;LI Yiqiu;HUA Chunhua;ZHU Daoping;LU Zhi;LI Huaiguo(Yingde People's Hospital,Qingyuan,Guangdong 513099,China)

机构地区：[1]英德市人民医院,广东清远513099

出　　处：《大医生》2020年第8期7-7,8-10,共4页Doctor

摘　　要：目的分析在高血压脑出血(HICH)患者中采取不同手术时机治疗对术后再出血及近期疗效的影响。方法选取2017年8月至2019年8月英德市人民医院收治的79例HICH患者作为研究对象,根据手术时机予以分组研究,33例发病6 h内接受手术治疗患者纳入超早期组,30例发病6~24 h接受手术治疗患者纳入早期组,16例发病24 h以上接受手术治疗患者纳入晚期组,对比分析三组术后再出血发生率、近期疗效、格拉斯哥昏迷指数(GCS)、血肿量。结果从术后再出血发生率来看,晚期组比超早期组和早期组低,同时早期组比超早期组低(P<0.05);从近期疗效来看,超早期组为93.94%,早期组为90.00%,晚期组为100%,三组对比差异无统计学意义(P>0.05);对GCS予以统计学分析,相比于手术前,手术后三组GCS评分提高(P<0.05),手术前后组间对比差异均无统计学意义(P>0.05)。对血肿量予以统计学分析,相比于手术前,手术后三组血肿量减少(P<0.05),手术前后组间对比差异均无统计学意义(P>0.05)。结论就HICH患者而言,不同手术时机均可以取得良好近期疗效,但手术时机越早,再出血概率越高,对此则需要做好术后监测工作,以避免术后再出血,保证近期疗效。Objective To analyze the influence of different operation time on the postoperative rebleeding and short-term curative effect in patients with hypertensive cerebral hemorrhage(HICH).Methods From August 2017 to August 2019,79 patients in Yingde People's Hospital with HICH were selected as the research objects,and they were divided into three groups according to the time of operation.Thirty-three patients who received surgical treatment within 6 h of onset were included in the super early group,30 patients who received surgical treatment within 6~24 h of onset were included in the early group,16 patients who received surgical treatment more than 24 hours of onset were included in the late group,and the three groups were analyzed after operation Blood incidence,short-term efficacy,Glasgow Coma index(GCS),hematoma volume.Results In terms of the incidence of postoperative rebleeding,the late group was lower than the ultra early group and the early group,while the early group was lower than the ultra early group(P<0.05);in terms of the short-term efficacy,the ultra early group was 93.94%,the early group was 90.00%,the late group was 100%,there was no statistical difference among the three groups(P>0.05);statistical analysis of GCs showed that compared with the pre operation,the three groups improved their GCS scores(P<0.05).There was no statistical difference between the groups before and after operation(P>0.05).The volume of hematoma was statistically analyzed.Compared with that before operation,the volume of hematoma in the three groups decreased after operation(P<0.05).There was no statistical difference between the groups before and after operation(P>0.05).Conclusion For patients with HICH,good short-term results can be achieved by different operation time,but the earlier the operation time is,the higher the probability of rebleeding is.Therefore,it is necessary to do a good job of postoperative monitoring to avoid rebleeding and ensure the short-term effect.

关 键 词：手术时机 高血压脑出血 术后再出血 近期疗效 

分 类 号：R65[医药卫生—外科学]