不同手术时机治疗与高血压脑出血患者术后再出血及近期疗效的关系研究

摘要

Objective:To discuss the relationship between timing of surgical intervention and postopera-tive recurrent hemorrhage and short-term efficacy in patients with hypertensive intracerebral hemorrhage ( HICH) .Method:129 patients with HICH were divided into the ultra-early group ( n=43 ) , the early group( n=43) , and the late group( n=43) , then the rate of postoperative rebleeding and short-term efficacy were contrasted amony the three groups.Result: There was no significantly difference in the excellent rate amony the three groups( P>0.05);the rate of postoperative rebleeding in the ultra-early group was 27.9%(12/43), which was significantly higher than 7.0%(3/43) in the early group and 2.3%(1/43) in the late group( P<0.05 or P<0.01) .Conclusion:Timing of surgical intervention is closely related with the postoper-ative rebleeding in patients with HICH, ultra-early operation can increase the rate of postoperative rebleed-ing and affects the prognosis.But the operation still should be performed as early as possible to save the lives of patients with faster bleeding and cerebral hernia maybe occurred in a short time.%目的：探讨不同手术时机对高血压脑出血（ HICH）患者术后再出血及近期疗效的影响。方法：129例HICH患者根据手术时机分为超早期组（n＝43）、早期组（n＝43）与晚期组（n＝43），均给予相同的手术方案治疗，对比三组患者近期疗效及术后再出血发生率。结果：三组患者治疗优良率比较无统计学差异（P＞0．05）；超早期组再出血率为27．9％（12／43），显著高于早期组的7．0％（3／43）与晚期组的2．3％（1／43）（P＜0．05或P＜0．01），早期组与晚期组术后再出血率比较无统计学差异（P＞0．05）。结论：HICH手术时机的选择与术后再出血密切相关，超早期手术可增加术后再出血发生率而影响预后，但对于出血速度较快，短时间内可能形成脑疝者，仍应尽早手术以挽救患者生命。