高血压脑出血不同手术时机与患者预后及生存质量的关系

目的 探讨高血压脑出血(HICH)不同手术时机与患者预后及生存质量的关系.方法 选择2013年1月至2016年6月期间在中国人民解放军南京军区福州总医院神经外科手术治疗的124例HICH患者为研究对象,根据手术时机的不同将出血至手术时间<6 h者60例纳入超早期组,6～24 h者64例纳入早期组,比较两组患者术后再出血率以及随访3个月时患者格拉斯哥预后评分(GOS)优良率、死亡率,并采用WHO生存质量评估简表(WHOQOL-BREF)评价患者生存质量.结果 超早期组与早期组患者术后再出血率分别为8.33％和6.25％,差异无统计学意义(P>0.05);术后随访3个月时,超早期组与早期组患者的死亡率分别为13.33％和15.63％,差异无统计学意义(P>0.05),但是超早期组患者的GOS预后评分优良率为78.33％,明显高于早期组的62.50％,差异有统计学意义(P<0.05);超早期组WHOQOL-BREF评分为(64.3±20.4)分,明显高于早期组的(53.7±18.1)分,差异有统计学意义(P<0.05).结论 对有手术适应证的高血压脑出血患者,超早期手术可有效改善患者的近期预后,提高其生存质量.

Relationship between the timing of surgery and prognosis and quality of life in patients with hypertensive intracerebral hemorrhage

Objective To investigate the relationship between the timing of surgery and prognosis and quality of life in patients with hypertensive intracerebral hemorrhage (HICH). Methods A total of 124 patients with HICH, who admitted to Department of Neurosurgery of our hospital from January 2013 to June 2016, were selected and divid-ed into the ultra-early group (<6 h, n=60) and the early group (6～24 h, n=64) according to the different timing of sur-gery. The postoperative rebleeding rate and the excellent rate and mortality of Glasgow outcome score (GOS) for fol-low-up of 3 months in the two groups were compared, and WHOQOL-BREF score was used to evaluate the life quali-ty. Results There was no significant difference in the postoperative rebleeding rate between the ultra-early group (8.33％) and the early group (6.25％) (P>0.05);after 3 months of follow-up, there was still no difference in the mortality between the ultra-early group (13.33％) and the early group (15.63％) (P>0.05). However, the GOS score excellent rate in the ultra-early group was 78.33％, which was significantly higher than 62.50％of the early group (P<0.05);the WHO-QOL-BREF score in the ultra-early group was (64.3±20.4), which was significantly higher than (53.7±18.1) in the con-trol group (P<0.05). Conclusion For patients with hypertensive cerebral hemorrhage who have indications of opera-tion, the ultra-early operation can effectively improve the short-term prognosis and the quality of life.