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中国临床研究:2020,33(2):163-166
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小骨窗显微术治疗高血压基底节区脑出血的时机选择及对患者预后的影响
(桂林市人民医院神经外科,广西 桂林541102)
Timing selection of smallbonewindow craniotomy microsurgery and its effect on prognosis in patients with hypertensive basal ganglia intracerebral hemorrhage
(Department of Neurosurgery,Guilin People′s Hospital,Guilin,Guangxi 541102,China)
摘要
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投稿时间:2019-05-26   网络发布日期:2020-02-20
中文摘要: 目的 探究小骨窗显微术治疗高血压基底节区脑出血的时机选择及对患者预后的影响。方法 对2015年1月至2017年6月在院内行小骨窗显微术治疗的高血压基底节区脑出血患者80例的临床资料进行回顾性分析,依据手术时机的不同进行分组。行早期手术的40例为对照组,手术时机为脑出血发生后6~48 h。行超早期手术的40例为观察组,手术时机为脑出血发生后6 h之内手术。比较两组预后疗效[日常生活功能(Barthel)指数评分、中国卒中患者神经功能缺损评分标准(CSS)、美国国立卫生研究所脑卒中评分(NIHSS)、副反应量表(TESS)评分];对患者术后随访6个月,观察再出血、再住院情况及术后并发症情况。结果术后1个月,观察组Barthel、CSS、NIHSS、TESS评分均低于对照组(P<0.05,P<0.01);术后6个月,两组以上评分接近,差异无统计学意义(P>0.05);两组术后6个月以上评分均高于术后1个月(P<0.01)。两组再出血、再住院发生率比较无统计学差异(P>0.05)。观察组并发症发生率低于对照组(5.00% vs 20.00%,χ2=4.114,P=0.043)。结论小骨窗显微术时机的选择对于预后具有一定影响,而超早期手术术后并发症发生风险较低,两种手术时机各有利弊,应结合患者实际情况做出最佳选择。
Abstract:Objective To explore the timing selection of smallbonewindow craniotomy microsurgery for cerebral hemorrhage on hypertensive basal ganglia and its effect on treatment emergent symptom scale(TESS) of patients.Methods A retrospective analysis was performed in 80 patients with cerebral hemorrhage on hypertensive basal ganglia,who received small bone window craniotomy microsurgery from January 2015 to June 2017 and divided into groups according to the different opportune moment of operation.The early operation was performed 6-48 hours after the occurrence of cerebral hemorrhage in control group,and ultraearly operation was performed within 6 hours after the occurrence of cerebral hemorrhage in observation group (n=40,each).Barthel activities of daily living index score (Barthel index),clinical neurological deficit of stroke patients[China Stroke Scale(CSS)],National Institutes of Health Stroke Scale (NIHSS) and TESS score were compared between two groups,and the patients were followed up for 6 months to observe the situation of rebleeding,rehospitalization and postoperative complications.Results One month after operation,the scores of Barthel index,CSS,NIHSS and TESS in observation group were significantly higher than those in control group (P<0.05,P<0.01),however,there were no statistical differences in them at six months after operation (P>0.05).After postoperative six months,the total scores were significantly higher than those of the first month after operation in two groups (P<0.01).There were no significant differences in the rates of rebleeding and readmission between two groups (P>0.05).The incidence of complications in observation group was significantly lower than that in control group (5.00% vs 20.00%,χ2=4.114,P=0.000).Conclusions In the treatment of cerebral hemorrhage on hypertensive basal ganglia,the timing selection of small bone window microsurgery has a certain effect on the prognosis of patients.The risk of complications after ultraearly operation is relatively low,and early operation has a little advantage in controlling rebleeding,so the best choice should be made according to the actual situation of patients.
文章编号:     中图分类号:    文献标志码:A
基金项目:广西壮族自治区卫生和计划生育委员会科研课题(z2015231)
引用文本:
冯屹,李斌,谭卫,汪洋,李传伟,钟文,钟伟.小骨窗显微术治疗高血压基底节区脑出血的时机选择及对患者预后的影响[J].中国临床研究,2020,33(2):163-166.

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