小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响

doi:10.3969/j.issn.1000-8535.2017.03.011

摘要/Abstract

摘要： 目的探讨小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响。方法选取我院2014年5月—2016年5月收治的80例高血压脑出血患者作为研究对象,脑出血量约30～40 mL,根据出血到手术时间不同分为两组,每组40例。从出血到手术时间<6 h者为超早期作为观察组,出血到手术时间处于6~24 h间者为早期作为对照组,比较两组患者治疗后1个月GOS(格拉斯哥预后)优良率,治疗后3周、6周的斯堪的纳维亚(SSS)评分,治疗后3个月、6个月的生存质量评分及治疗后的生存情况、再出血情况。结果观察组治疗后1个月GOS优良率为77.50%,相对于对照组明显上升(P<0.05);观察组治疗后3周、6周的SSS评分较对照组明显降低(P<0.01);观察组治疗后3个月、6个月的生存质量评分较对照组明显升高(P<0.01);两组治疗后的生存率差异有统计学意义(P<0.05),再出血率差异无统计学意义(P>0.05)。结论对高血压脑出血患者在超早期行小骨窗显微手术可提高疗效,明显改善患者神经功能,提高生活质量及生存率,值得临床推广。

关键词: 小骨窗显微手术, 高血压脑出血, 疗效, 神经功能

Abstract: Objective To investigate the curative effects of microsurgical treatment with small bone flap craniotomy in patients with hypertensive cerebral hemorrhage and on their nerve function in different timing of surgery. Methods To select 80 cases of hypertensive cerebral hemorrhage in our hospital from May 2014 to May 2016 as the research object. The amount of cerebral hemorrhage of the patients was about 30-40 mL. According to the different time of bleeding, they were divided into two groups, 40 cases in each group. The super early period that the time from bleeding to operation was less than 6 h was regarded as the observation group, and the early period that the time from bleeding to operation is during 6~24 h was regarded as the control group. To compare the GOS (Glasgow outcome) excellent rate of patients in two groups in 1 month after treatment, the Scandinavia (SSS) score in 3 weeks and 6 weeks after treatment, and the quality of life score and survival and re-bleeding condition after treatment in 3 months and 6 months. Results Compared with the control group, the GOS excellent rate in the observation group in 1 month after treatment was 77.50% which increased significantly (P<0.05); the SSS score in the observation group in 3 weeks and 6 weeks after treatment was significantly lower than that in the control group (P<0.01); The quality of life score in the observation group in 3 months and 6 months after treatment was significantly higher than that in the control group (P<0.01); There was statistically significant difference in survival rate between the two groups after treatment (P<0.05), and the re-bleeding rate showed no significant difference (P>0.05). Conclusion The curative effects of microsurgical treatment with small bone flap craniotomy on patients with hypertensive cerebral hemorrhage is significant, which can improve the patients' neurological function, the life quality and survival rate, thus it is worthy of clinical promotion.

Key words: Microsurgical treatment with small bone flap craniotomy, Hypertensive cerebral hemorrhage, Curative effect, Nerve function

王育胜, 洪映标, 黄正华, 彭晖. 小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响[J]. 广州医药, 2017, 48(3): 46-48.

WANG Yusheng, HONG Yingbiao, HUANG Zhenghua, PENG Hui. Curative effects of microsurgical treatment with small bone flap craniotomy on patients with hypertensive cerebral hemorrhage and on their nerve function in different timing of surgery[J]. Guangzhou Medical Journal, 2017, 48(3): 46-48.

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小骨窗显微手术不同手术时机对高血压脑出血患者疗效及神经功能的影响

Curative effects of microsurgical treatment with small bone flap craniotomy on patients with hypertensive cerebral hemorrhage and on their nerve function in different timing of surgery

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