高血压脑出血手术治疗时间的选择及疗效差异比较
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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 difference of curative effect 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 hematomapuncture clearance. Results The curative effect of the super earlyoperation group was significantly higher than that in the early group andthe non early group, but the early group was higher than the non earlygroup. The incidence of postoperative complications and rebleedingin the craniotomy group was significantly higher than that in the smallbone window operation group and the minimally invasive group, whilethe small bone window hand was higher than the minimally invasivegroup. The prognosis of the super early group was significantly higherthan that in the early group and the non early group, but the early groupwas higher than that in the non early group. Conclusion The surgicaltreatment of hypertensive cerebral hemorrhage and time, directly affectthe therapeutic effect and prognosis of patients with surgical treatment,and the choice of ultra early surgery time less than 6 h, can effectivelyimprove the prognosis, reduce the incidence of rebleeding, improvepatient survival rate and disability rate.
Objective To explore the choice of operation time and the difference of curative effect 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 hematomapuncture clearance. Results The curative effect of the super earlyoperation group was significantly higher than that in the early group andthe non early group, but the early group was higher than the non earlygroup. The incidence of postoperative complications and rebleedingin the craniotomy group was significantly higher than that in the smallbone window operation group and the minimally invasive group, whilethe small bone window hand was higher than the minimally invasivegroup. The prognosis of the super early group was significantly higherthan that in the early group and the non early group, but the early groupwas higher than that in the non early group. Conclusion The surgicaltreatment of hypertensive cerebral hemorrhage and time, directly affectthe therapeutic effect and prognosis of patients with surgical treatment,and the choice of ultra early surgery time less than 6 h, can effectivelyimprove the prognosis, reduce the incidence of rebleeding, improvepatient survival rate and disability rate.
引文
[1]翟景光,王卫亚,肖尚领.微创置管与开颅手术治疗高血压脑出血的临床效果比较[J].黑龙江医药,2017,30(5):1102-1104.
[2]程益林,刘志鹏.高血压脑出血小骨窗微创手术治疗时机及预后分析[J].浙江创伤外科,2017,22(4):655-656.
[3]王振宇.高血压脑出血行小骨窗微创脑出血清除术治疗的疗效评价[J].中国医学创新,2017,14(24):87-89.
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[6]宋红伟,张小霞.微创钻孔引流术与小骨窗开颅术治疗中等量基底节区高血压脑出血的临床效果[J].现代诊断与治疗,2017,28(12):2170-2171.
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[8]庞红立,魏立平,李文波.早期微创手术与保守治疗小量基底核区高血压脑出血的疗效及预后比较[J].中国实用神经疾病杂志,2017,20(9):94-96.
[9]侯振声.高血压脑出血的手术治疗时机分析与研究[J].血管与腔内血管外科杂志,2017,3(3):773-775.
[10]王宏宇.微创颅内血肿清除术治疗高血压脑出血的临床疗效观察[J].基层医学论坛,2017,21(8):949-950.
[11]陈纪欢.早期微创颅内血肿清除术治疗高血压脑出血的临床效果分析[J].中外医学研究,2018,16(3):20-21.
[12]孙广卫,司马国忠,王猛.不同术式治疗高血压脑出血的疗效分析[J].中国继续医学教育,2016,8(9):112-113.
[13]段吉强,姚胜,王阳,等.不同手术时机治疗高血压脑出血的临床效果对比[J].中国医药导报,2018,15(2):71-74.
[2]程益林,刘志鹏.高血压脑出血小骨窗微创手术治疗时机及预后分析[J].浙江创伤外科,2017,22(4):655-656.
[3]王振宇.高血压脑出血行小骨窗微创脑出血清除术治疗的疗效评价[J].中国医学创新,2017,14(24):87-89.
[4]田钧,赵海康,李侠.老年高血压脑出血早期个体化手术230例疗效分析[J].中华神经外科疾病研究杂志,2017,16(4):313-316.
[5]刘书考.微创颅内血肿清除术治疗高血压脑出血的临床疗效[J].心血管病防治知识(学术版),2017(7):12-14.
[6]宋红伟,张小霞.微创钻孔引流术与小骨窗开颅术治疗中等量基底节区高血压脑出血的临床效果[J].现代诊断与治疗,2017,28(12):2170-2171.
[7]胡振宇,雍成明,宣家龙.老年高血压脑出血患者超早期手术治疗的临床疗效[J].医学综述,2017,23(5):1030-1033.
[8]庞红立,魏立平,李文波.早期微创手术与保守治疗小量基底核区高血压脑出血的疗效及预后比较[J].中国实用神经疾病杂志,2017,20(9):94-96.
[9]侯振声.高血压脑出血的手术治疗时机分析与研究[J].血管与腔内血管外科杂志,2017,3(3):773-775.
[10]王宏宇.微创颅内血肿清除术治疗高血压脑出血的临床疗效观察[J].基层医学论坛,2017,21(8):949-950.
[11]陈纪欢.早期微创颅内血肿清除术治疗高血压脑出血的临床效果分析[J].中外医学研究,2018,16(3):20-21.
[12]孙广卫,司马国忠,王猛.不同术式治疗高血压脑出血的疗效分析[J].中国继续医学教育,2016,8(9):112-113.
[13]段吉强,姚胜,王阳,等.不同手术时机治疗高血压脑出血的临床效果对比[J].中国医药导报,2018,15(2):71-74.