临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
19期
1613-1615
,共3页
高血压脑出血%基底节区%小骨窗显微手术%最佳手术时间窗
高血壓腦齣血%基底節區%小骨窗顯微手術%最佳手術時間窗
고혈압뇌출혈%기저절구%소골창현미수술%최가수술시간창
Hypertensive cerebral hemorrhage%Basal ganglia%Small skull window microsurgery%Optimal timing
目的：探讨小骨窗显微手术治疗基底节区高血压性脑出血手术时间与预后的关系，寻求其最佳手术治疗时间窗。方法100例高血压脑出血患者随机抽签筛选出60例作为研究对象，并将其随机分为三组，每组20例。分别为超早期手术组（<7 h），早期手术组（7~12 h内），延期手术组（12 h以后）。三组均实施小骨窗显微手术治疗。观察三组患者住院期间的再出血率、病死率及术后6个月日常生活自理能力。结果①再出血率：超早期、早期和延期手术组再出血率分别为15.0％、35.0％和80.0％，延期手术组显著高于其他两组（ P <0.001，P <0.01）。②病死率：超早期、早期和延期手术组再出血率分别为15.0％、40.0％和60.0％，延期手术组显著高于超早期手术组（ P <0.01）。③术后6个月日常生活能力：越早手术，生活质量越好，但三组间未达统计学差异。结论出血后7h内手术是小骨窗显微手术治疗基底节区高血压性脑出血的最佳手术时间窗。
目的：探討小骨窗顯微手術治療基底節區高血壓性腦齣血手術時間與預後的關繫，尋求其最佳手術治療時間窗。方法100例高血壓腦齣血患者隨機抽籤篩選齣60例作為研究對象，併將其隨機分為三組，每組20例。分彆為超早期手術組（<7 h），早期手術組（7~12 h內），延期手術組（12 h以後）。三組均實施小骨窗顯微手術治療。觀察三組患者住院期間的再齣血率、病死率及術後6箇月日常生活自理能力。結果①再齣血率：超早期、早期和延期手術組再齣血率分彆為15.0％、35.0％和80.0％，延期手術組顯著高于其他兩組（ P <0.001，P <0.01）。②病死率：超早期、早期和延期手術組再齣血率分彆為15.0％、40.0％和60.0％，延期手術組顯著高于超早期手術組（ P <0.01）。③術後6箇月日常生活能力：越早手術，生活質量越好，但三組間未達統計學差異。結論齣血後7h內手術是小骨窗顯微手術治療基底節區高血壓性腦齣血的最佳手術時間窗。
목적：탐토소골창현미수술치료기저절구고혈압성뇌출혈수술시간여예후적관계，심구기최가수술치료시간창。방법100례고혈압뇌출혈환자수궤추첨사선출60례작위연구대상，병장기수궤분위삼조，매조20례。분별위초조기수술조（<7 h），조기수술조（7~12 h내），연기수술조（12 h이후）。삼조균실시소골창현미수술치료。관찰삼조환자주원기간적재출혈솔、병사솔급술후6개월일상생활자리능력。결과①재출혈솔：초조기、조기화연기수술조재출혈솔분별위15.0％、35.0％화80.0％，연기수술조현저고우기타량조（ P <0.001，P <0.01）。②병사솔：초조기、조기화연기수술조재출혈솔분별위15.0％、40.0％화60.0％，연기수술조현저고우초조기수술조（ P <0.01）。③술후6개월일상생활능력：월조수술，생활질량월호，단삼조간미체통계학차이。결론출혈후7h내수술시소골창현미수술치료기저절구고혈압성뇌출혈적최가수술시간창。
Objective To explore the outcome of different timing for microsurgery through small skull window for treatment of patients with hypertensive basal ganglia cerebral hemorrhage. Methods Sixty of 100 patients with hypertensive intracranial hemorrhage admitted in this hospital were randomly divided into three groups,ultra-early group(within 7 hours),early group(7 to 12 hours)and postponed operation group(over 12 hours). Small skull window microsurgery had been applied in all 85 cases. The incidence of re-bleeding,mortality and activities of daily living were evaluated in each group. Results The incidence rates of re-bleeding in ultra-early group,early group,and postponed operation group were 15. 0%,35. 0% and 80. 0% respectively,while the latter was obviously higher than the former two groups( P <0. 001,P <0. 01). The mortality was 15. 0% in ultra-early group,40. 0% in early group,and 60. 0% in postponed operation group,and it in postponed operation group was significantly higher than that of ultra-early group( P <0. 01). The quality of life was better in patients received earlier operation,but there was no notable alteration among three groups. Conclusion The optimal timing for removal of basal ganglia hematoma by using small skull window microsurgery is within 7 hours after the onset of hemorrhage.
