微创穿刺术治疗高血压性脑出血手术时机的选择

目的:观察不同手术时机对微创穿刺术治疗高血压脑出血疗效和预后的影响。方法:将241例高血压脑出血患者根据发病至手术间隔时间分为3组:超早期组（n=80）、早期组（n=81）和延迟组（n=80）。各组患者均行微创穿刺术，以格拉斯哥预后评分优良率比较各组术后2周治疗效果，术后3个月Barthel指数评价优良率，以及患者远期功能恢复情况、术后并发症和术后再出血情况。结果:超早期组患者术后2周格拉斯哥预后评分总优良率及术后3个月Barthel指数评分总优良率均高于其他2组（P<0.05～P<0.01），3组患者术后再出血率差异有统计学意义（P<0.05），而3组其他并发症发生率差异均无统计学意义（P>0.05）。结论:超早期行微创穿刺术有利于高血压脑出血患者近期及远期功能恢复，是较为理想的手术时机。

Effect of the surgery timing on the minimally invasive puncture in the treatment of hypertensive intracerebral hemorrhage

Objective:To observe the effects of the surgery timing on the minimally invasive puncture in the treatment of hypertensive intracerebral hemorrhage. Methods:Two hundred and forty-one patients with hypertensive intracerebral hemorrhage were divided into the ultra-early group(80 cases),early group(81 cases) and late group(80 cases) according to the operation time after the onset of hemorrhage. All patients were treated with the minimally invasive surgery,and the clinical effects between three groups were compared with the excellent rates of Glasgow Outcome Scale at postoperative 2 weeks,and Barthel Index Scale at postoperative 3 months. The long-term functional recovery,postoperative complications and re-bleeding between three groups were compared. Results:The excellent rates of Glasgow Outcome Scale at postoperative 2 weeks,and Barthel Index Scale at postoperative 3 months in ultra-early group were higher than those in other two groups(P <0. 05 to P <0. 01). The differences of the incidence of re-bleeding between three groups were statistically significant(P<0. 05),but the differences of the incidence of complications between three groups were not statistically significant(P>0. 05). Conclusions:The minimally invasive surgery at ultra-early stage can be beneficial to the short-term and long-term functional recovery of patients with hypertensive intracerebral hemorrhage,which is an ideal surgery timing.