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高血压脑出血患者的手术时机及方式与疗效的关系(1)
http://www.100md.com 2015年10月5日 中国医学创新 2015年第28期
     【摘要】 目的:观察高血压脑出血患者的手术时机及方式与疗效的关系。方法:选取本院2011年6月-2013年6月收治的高血压脑出血患者140例,依据患者从发病到手术时间的不同分为A、B、C三组,A组患者50例,出血时间<7 h,B组患者40例,出血时间7~24 h,C组患者50例,出血时间>24 h。根据患者出血部位以及出血量的不同而选择骨瓣开颅术、颅骨钻孔术和小骨窗开颅术等手术方式,观察并比较患者的疗效及预后情况。结果:A组总有效率为92.00%(46/50)显著高于B组和C组的75.00%(30/40)和50.00%(25/50)(P<0.05);B组的总有效率显著高于C组(P<0.05);A组好转率88.00%(44/50)显著高于B组和C组的70.00%(28/40)和36%(18/50)(P<0.05);B组的好转率显著高于C组(P<0.05);A组病死率为2.00%(1/50)显著低于B组和C组的7.50%(3/40)和16%(8/50)(P<0.05);B组的病死率显著低于C组(P<0.05)。结论:手术时机以及手术方式对高血压脑出血患者的疗效及预后具有重要的影响。
, http://www.100md.com
    【关键词】 高血压; 脑出血; 手术时机; 手术方式; 疗效

    【Abstract】 Objective: To observe the relationship between hypertensive intracerebral hemorrhage timing and manner of operation and efficacy. Method: 150 patients with hypertensive intracerebral hemorrhage in our hospital from June 2011 to June 2013 were selected, according to the patients with different time from onset to surgery were divided into A, B, C three groups, A group contained 50 patients , bleeding less than 7 h, 40 patients in group B, bleeding time between 7-24 h, 50 patients in group C, bleeding time greater than 24h. Depending on the amount of bleeding in patients with a bleeding site and choose craniotomy, burr hole surgery and small bone window craniotomy and other surgical procedures, observe and compare the efficacy and prognosis of patients. Result: Group A total effective rate was 92.00% (46/50) was significantly higher than 75.00% (30/40) in group B and 50.00% (25/50) in group C (P<0.05); and group B was significantly higher than group C (P<0.05); A group improvement rate was 88.00% (44/50), which was significantly higher than 70.00% (28/40) in group B and 36% (18/50) in group C (P<0.05); improvement rate of group B was significantly higher than group C (P<0.05); A group mortality was 2.00% (1/50 ), which was significantly lower than 7.50% (3/40) in group B and 16% (8/50) in group C (P<0.05); mortality in group B was significantly lower than in group C (P<0.05). Conclusion: The timing of surgery and the surgical approach has an important impact on the treatment and prognosis of patients with hypertensive intracerebral hemorrhage.
, 百拇医药
    【Key words】 Hypertension; Cerebral hemorrhage; Timing of surgery; Surgical approach; Efficacy

    First-author’s address: Wanjiang Regionalism of Dongguan People’s Hospital, Dongguan 523000, China

    doi:10.3969/j.issn.1674-4985.2015.28.009

    高血压是最常见的慢性病,也是心脑血管疾病最主要的危险因素。全世界超过1/3的成年人患有高血压,这一比例随年龄而增长,在二三十岁的人群中占1/10,在50多岁的人群中占到5/10[1]。高血压已成为我国居民健康的头号杀手。高血压患者血管脆性增加,极易引起脑出血,严重影响患者的生存质量[2]。而随着社会的发展,人们生活方式的改变、环境的改变以及我国老龄化人口的增加等因素均显著增加了高血压脑出血发病风险,对于高血压脑出血患者最常用的治疗方法为手术治疗,然而手术时机及方式的选择对疗效会产生不同的影响。本研究主要探讨高血压脑出血患者的手术时机及方式与疗效的关系。, http://www.100md.com(方志伟)
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