不同术式超早期治疗高血压脑出血的近期疗效与中远期预后效果分析

摘要

目的：探讨不同术式超早期治疗高血压脑出血的近期疗效与中远期预后效果。方法将247例高血压脑出血患者分为A、B、C3组，分别采用血肿穿刺抽吸引流术、小骨窗开颅手术以及大骨瓣开颅手术进行治疗。结果组间比较A、B、C3组患者的术后1个月存活率，A组略高于B组与C组，但两两比较差异均无统计学意义（χ2AB ＝0．276，PAB＝0．814；χ2AC ＝0．312，PAC ＝0．665；χ2BC ＝0．283，PBC ＝0．802）；组间比较A、B、C 3组患者的术后6月的日常生活能力（ADL ）分级情况，A组（60．5％）显著优于B组（36．6％）和C组（31．6％），进行组间比较，差异均有统计学意义（χ2AB ＝7．906，PAB ＝0．027；χ2AC ＝8．114，PAC ＝0．016），B组与C组比较差异无统计学意义（χ2BC ＝0．147，PBC ＝0．933）。结论临床针对高血压脑出血患者应首先考虑血肿穿刺引流辅助开颅血肿清除术。%Objective to explore the super early treatment effect of different operative methods to the recent efficacy and long-term prognosis of hypertensive cerebral hemorrhage .Methods 247 patients with hypertensive cere-bral hemorrhage was divided into three groups A ,B ,C ,respectively ,using hematoma puncture pumping attract flow , small bone window craniotomy surgery and big bone flap craniotomy surgery for treatment .Results A group surviv-al rate of patients after one month treatment was slightly higher than that of group B and group C ,but there is no sta-tistical significance(χ2AB =0 .276 ,PAB =0 .814 ;χ2AC =0 .312 ,PAC =0 .665;χ2BC =0 .283 ,PBC =0 .802);between group A and B ,C of three groups of patients with six months postoperative statistics by ADL grading situation of crop ,its of A group (60 .5% ) was significantly better than that of group B(36 .6% ) and group C(31 .6% ) ,there was statistical significance(χ2AB =7 .906 ,PAB =0 .027 ;χ2AC =8 .114 ,PAC =0 .016) ,while that of group B compared with its of group C ,there was no statistical significance(χ2BC =0 .147 ,PBC =0 .933) .Conclusion Removal of hematoma puncture drain-age of auxiliary craniotomy hematoma should be the first application for Cerebral hemorrhage .