中国实用神经疾病杂志
中國實用神經疾病雜誌
중국실용신경질병잡지
CHINESE JOURNAL OF PRACTICAL NERVOUS DISEASES
2015年
3期
29-31
,共3页
高血压脑出血%立体定向手术%预后%影响因素
高血壓腦齣血%立體定嚮手術%預後%影響因素
고혈압뇌출혈%입체정향수술%예후%영향인소
Hypertensive intracerebral hemorrhage%Stereotactic surgery%Prognosis%Influencing factors
目的：探讨立体定向手术治疗高血压脑出血的效果及影响预后的因素。方法87例高血压脑出血患者根据治疗方式分为传统保守治疗组（44例）和立体定向手术治疗组（43例）。分别比较治疗后2组患者出血量变化、临床疗效及日常生活活动（activity of daily living scale ，ADL ）量表评分的改变，分析2组预后的影响因素。结果2组患者治疗后7 d、30 d出血量均明显减少（P＜0.05），立体定向组在治疗后7 d、30 d的出血量均显著低于传统组（P＜0.05）。传统组总有效率（45.45％，20／44）明显低于立体定向组（77.27％，34／43），生活自理能力改善程度优于传统组（P＜0.05）。Logistic回归分析结果显示，高血压病程（β＝0.736，P＝0.037）、GCS评分（β＝0.829，P＝0.023）和体重指数（β＝2.19，P＝0.017）为传统组的独立高危影响因素；而GCS评分（β＝0.799，P＝0.010）和高血压病程（β＝0.616，P＝0.004）为立体定向组的独立高危因素。结论相比传统保守治疗，立体定向手术治疗可明显改善高血压脑出血患者的临床症状，促进疾病的预后。
目的：探討立體定嚮手術治療高血壓腦齣血的效果及影響預後的因素。方法87例高血壓腦齣血患者根據治療方式分為傳統保守治療組（44例）和立體定嚮手術治療組（43例）。分彆比較治療後2組患者齣血量變化、臨床療效及日常生活活動（activity of daily living scale ，ADL ）量錶評分的改變，分析2組預後的影響因素。結果2組患者治療後7 d、30 d齣血量均明顯減少（P＜0.05），立體定嚮組在治療後7 d、30 d的齣血量均顯著低于傳統組（P＜0.05）。傳統組總有效率（45.45％，20／44）明顯低于立體定嚮組（77.27％，34／43），生活自理能力改善程度優于傳統組（P＜0.05）。Logistic迴歸分析結果顯示，高血壓病程（β＝0.736，P＝0.037）、GCS評分（β＝0.829，P＝0.023）和體重指數（β＝2.19，P＝0.017）為傳統組的獨立高危影響因素；而GCS評分（β＝0.799，P＝0.010）和高血壓病程（β＝0.616，P＝0.004）為立體定嚮組的獨立高危因素。結論相比傳統保守治療，立體定嚮手術治療可明顯改善高血壓腦齣血患者的臨床癥狀，促進疾病的預後。
목적：탐토입체정향수술치료고혈압뇌출혈적효과급영향예후적인소。방법87례고혈압뇌출혈환자근거치료방식분위전통보수치료조（44례）화입체정향수술치료조（43례）。분별비교치료후2조환자출혈량변화、림상료효급일상생활활동（activity of daily living scale ，ADL ）량표평분적개변，분석2조예후적영향인소。결과2조환자치료후7 d、30 d출혈량균명현감소（P＜0.05），입체정향조재치료후7 d、30 d적출혈량균현저저우전통조（P＜0.05）。전통조총유효솔（45.45％，20／44）명현저우입체정향조（77.27％，34／43），생활자리능력개선정도우우전통조（P＜0.05）。Logistic회귀분석결과현시，고혈압병정（β＝0.736，P＝0.037）、GCS평분（β＝0.829，P＝0.023）화체중지수（β＝2.19，P＝0.017）위전통조적독립고위영향인소；이GCS평분（β＝0.799，P＝0.010）화고혈압병정（β＝0.616，P＝0.004）위입체정향조적독립고위인소。결론상비전통보수치료，입체정향수술치료가명현개선고혈압뇌출혈환자적림상증상，촉진질병적예후。
Objective To investigate the clinical effect of stereotactic surgery for hypertensive intracerebral hemorrhage and the factors affecting prognosis of the disease .Methods We retrospectively analyzed 90 cases of hypertensive cerebral hem‐orrhage patients in our hospital from January 2012 to January 2014 .The patients were divided into traditional and conservative treatment group (44 cases) and stereotactic surgery group (43 cases) according to the different treatments .Bleeding ,clinical efficacy and activities of daily living (ADL) scores ,cellular changes in immunological parameters were compared between two groups ,and prognostic factors in both groups were analyzed .Results Bleeding were significantly reduced in both conventional therapy group and the stereotactic group at 7 and 30 days after treatment (P<0.05) ,the amount of bleeding in stereotactic treatment group were only 53 .33 and 25 .19 percent of traditional group in each time ,which were significantly lower than the conventional group (P<0.05) .Total effective rate of traditional group (45.45 ,20/44) was significantly lower than that of stereotactic group (77.27% ,34/43). Self‐care ability improved extent were also superior in stereotactic group than in tradi‐tional group (P<0.05). Logistic regression analysis showed that the duration of hypertension (β=0.736 , P=0.037) ,GCS score (β=0.829 ,P=0.023) and BMI (β=2.19 ,P=0.017) were independent risk factors in traditional group;but independ‐ent risk factors were GCS score (β=0.799 , P= 0.010) and duration of hypertension (β=0.616 , P= 0.004) in stereotactic group. Conclusion Compared to conventional conservative treatment ,surgery can significantly improve the orientation of clini‐cal symptoms in patients with hypertensive cerebral hemorrhage ,and promote the prognosis of the disease.
