不同微创穿刺引流时间窗对高血压基底节脑出血患者预后的影响  

Effect of minimally invasive puncture and drainage in different time windows on the prognosis of patients with hypertensive basal ganglia hemorrhage

作　　者：贺建辉[1] 武利伟 王伟林 宫辛 胡耀文 刘振杰[1] 董海青[1] HE Jianhui;WU Liwei;WANG Weilin;GONG Xin;HU Yaowen;LIU Zhenjie;DONG Haiqing(Baoding NO.1 Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院,河北保定071000

出　　处：《中国实用神经疾病杂志》2024年第11期1382-1386,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河北省2020年度医学科学研究课题(编号:20200169)。

摘　　要：目的比较不同微创穿刺引流时间窗下高血压基底节脑出血患者的临床疗效及对预后的影响。方法回顾性收集保定市第一中心医院神经外科行微创穿刺引流术的150例高血压基底节脑出血患者的相关资料,采集时间2020-01—2023-01,按不同时间窗将患者分为超早期组(于发病6 h内实施手术)、早期组(于发病6~24 h内实施手术)与延期组(于发病24 h后实施手术)各50例。比较3组患者手术情况,采用美国国立卫生研究院卒中量表(NIHSS)及日常生活活动量表(ADL)评估治疗前后神经功能及生活质量的变化,并统计各组疗效及预后情况。结果早期组术后3 d血肿残余量明显(7.84±1.94)mL少于超早期组(10.23±2.56)mL与延期组(12.30±2.22)mL,且住院时间(15.02±6.13)d也明显短于超早期组(18.38±5.41)d与延期组(20.57±5.88)d(P<0.05);治疗后各组NIHSS评分均降低,ADL评分均升高(P<0.05),早期组各评分改善情况最显著(P<0.05);超早期组、早期组、延期组临床有效率分别为74.00%、94.00%、70.00%,早期组明显高于超早期组与延期组(P<0.05),但超早期组与延期组比较,差异无统计学意义(P>0.05);3组格拉斯哥预后量表(GOS)分级情况显示,早期组优于超早期组与延期组,差异有统计学意义(P<0.05)。结论微创穿刺引流治疗高血压基底节脑出血疗效显著,但以发病6~24 h进行手术的效果更为理想,其不仅能加快术后恢复,缩短住院时间,还可在提高患者神经功能及生活质量的同时改善术后预后情况。Objective To compare the clinical effects of minimally invasive puncture and drainage in different time windows in patients with hypertensive basal ganglia hemorrhage,and the influence on prognosis.Methods The data of 150 patients with hypertensive basal ganglia hemorrhage who underwent minimally invasive puncture and drainage in Baoding NO.1 Central Hospital from January 2020 to January 2023 were collected retrospectively.Patients enrolled were divided into the ultra-early group(surgery performed within 6 hours after onset),the early group(surgery performed within 6-24 hours after onset),and the delayed group(surgery performed at least 24 hours after onset)according to different time windows,with 50 patients in each group.Surgical conditions of the three groups were compared.The National Institutes of Health stroke scale(NIHSS)and activity of daily living(ADL)were used to evaluate neurological function and quality of life before and after treatment.Curative effects and prognosis of different groups were analyzed statistically.Results On the 3rd day after surgery,residual amount of hematoma in the early group(7.84±1.94)was smaller than that in the ultra-early group(10.23±2.56)and that in the delayed group(12.30±2.22).The length of hospital stay(15.02±6.13)was significantly shorter than that of the ultra-early group(18.38±5.41)and that in the delayed group(20.57±5.88)(P<0.05).After treatment,the NIHSS scores decreased and the ADL scores increased in all groups(P<0.05).The improvement of scores in the early group was the most significant(P<0.05).The clinical effective rates of the ultra-early group,the early-group,and the delayed group were 74.00%,94.00%and 70.00%,respectively.The clinical effective rate of the early group was significantly higher than that of the ultra-early group or the delayed group(P<0.05),but there was no statistically significant difference between the ultra-early group and the delayed group(P>0.05).The Glasgow outcome scale(GOS)grading of the early group was superior to that of the ult

关 键 词：微创穿刺引流 时间窗 高血压基底节脑出血 认知功能 生活质量 

分 类 号：R743.34[医药卫生—神经病学与精神病学]