超早期手术治疗高血压脑出血患者的临床疗效研究.docVIP

超早期手术治疗高血压脑出血患者的临床疗效研究 　　【摘要】 目的 探讨超早期手术治疗高血压脑出血的临床效果。方法 61例高血压脑出血患者 ， 根据手术时间不同分为实验组（31例， 发病6 h内进行手术）和对照组（30例， 发病后7～72 h进行手术）， 两组均给予小骨窗手术治疗。比较两组近期疗效及日常生活能力改善情况。结果 手术治疗后1个月， 实验组格拉斯哥昏迷评分（GCS）及优良率显著高于对照组（P0.05）；手术治疗后6个月， 实验组日常生活能力量表（ADL）分级Ⅰ～Ⅱ级比例显著高于对照组（P0.05）；实验组并发症发生率显著低于对照组（P0.05）。结论 术前准确评估患者病情后行超早期手术治疗高血压脑出血疗效显著优于早期手术， 术后并发症发生率低， 患者恢复良好， 值得临床推广应用。 　　【关键词】 超早期；小骨窗手术；高血压；脑出血；格拉斯哥昏迷评分；日常生活能力量表 　　【Abstract】 Objective To investigate clinical effect by ultra-early operation in the treatment of hypertensive cerebral hemorrhage. Methods A total of 61 patients with hypertensive cerebral hemorrhage were divided by different operation time into experimental group （31 cases， receiving operation within 6 h after disease attack） and control group （30 cases， receiving operation in 7～72 h after disease attack）. Both groups received small bone window operation. Short-term curative effect and improvement of activities of daily living were compared. Results After 1 month of operation， the experimental group had obviously higher Glasgow coma scale （GCS） and good rate than the control group （P0.05）. After 6 months of operation， the experimental group had much higher proportion of grade Ⅰ～Ⅱ in activities of daily living scale （ADL） than the control group （P0.05）. The experimentl group also had obviously lower incidence of complications than the control group （P0.05）. Conclusion Implement of ultra-early operation in the treatment of hypertensive cerebral hemorrhage after accurate evaluation of patient condition can provide remarkably better curative effect than early operation. This method shows low incidence of complications and good rehabilitation in patients. It is worth clinical promotion and application. 　　【Key words】 Ultra-early； Small bone window； Hypertension； Cerebral hemorrhage； Glasgow coma scale； Activities of daily living scale 　　高血压脑出血是指非外伤导致的脑实质内出血， 该病起病急， 病情进展快， 死亡率高[1]， 为高血压病最严重的并发症之一， 临床以突发的头痛、眩晕、肢体偏瘫、失语、意识障碍为主要表现[2]。目前， 临床多数学者主张采用外科手术治疗， 手术目的为尽可能清除血肿， 减少血肿对正常脑组