高血压脑出血患者术后再出血的不同手术治疗时机与近期疗效观察

摘要

目的：探讨高血压脑出血患者术后再出血的不同手术治疗时机与近期疗效。方法：收治HICH术后再出血患者290例，根据发病至手术时间的长短，分为晚期组、早期组和超早期组，结合患者具体情况予以适当的手术，比较3组的治疗效果。结果：3组再出血率相比，差异有统计学意义P＜0.05)；两两比较，超早期组的再出血率高于早期组和晚期组(P＜0.05)；早期组再出血率高于晚期组(P＞0.05)。3组的病死率差异不具有统计学意义(P＞0.05)。3组间两两比较，早期疗效中，死亡率和优良率的差异不具有统计学意义(P＞0.05)。结论：高血压脑出血术后患者再出血手术时机定在7～24 h，不仅能降低再出血的发生，也能提高临床疗效和预后。%Objective:To explore the different surgical timing for rehaemorrhagia after operation of hypertensive cerebral hemorrhage patients and recent curative effect observation.Methods:290 patients with rehaemorrhagia after operation of hypertensive cerebral hemorrhage were selected.According to the length of time from stroke onset to operation,they were divided into the late group,early group,and ultra early group.Combined with the specific circumstances of the patients,they were given appropriate operation.We compared the treatment effect of three groups.Results:There was significant difference in the rate of rehaemorrhagia in the 3 groups(P<0.05).Comparison between each group,the rate of rehaemorrhagia in the ultra early group was higher than that in the early group and late group(P<0.05);the rate of rehaemorrhagia in the early group was higher than that in the late group(P>0.05).The difference of case fatality rate between the 3 groups was not significant(P>0.05).Two-by-two comparison between groups,in the early efficacy,the mortality rate and the excellent rate was not statistically significant(P>0.05). Conclusion:The operation opportunity from 7 to 24 hours for rehaemorrhagia after operation of hypertensive cerebral hemorrhage patients not only can reduce the incidence of rehaemorrhagia,but also can improve the clinical efficacy and prognosis.