血肿清除时机对高血压脑出血预后转归的影响

目的 探讨高血压脑出血不同手术时机对临床预后的影响.方法 本组125例高血压脑出血患者,按发病至手术开始的时间分组,8 h内（超早期组）38例,8～24 h内（早期组）46例,24 h后（晚期组）41例,分别对术后再出血发生率、神经功能恢复状态以及病死率进行比较.结果 超早期组术后再出血发生率高（P〈0.05）,超早期组功能恢复良好者多于早期组和晚期组（P〈0.05）;3组患者病死率差异无统计学意义 （P＞0.05）.结论 超早期手术清除血肿可降低术后神经功能缺陷,提高生存质量.可通过术中血压监测、有效止血、术后控制血压等综合治疗降低再出血发生率.

The effect of timing for hematoma removal to prognosis of hypertensive intracerebral hemorrhage

Objective To investigate the effects of different operation timing for hematoma removal on clinical prognosis of hypertensive intracerebral hemorrhage. Methods 125 patietns were divided into 3 groups,of which 38 patients were operated within 8 hours（ultra-early Group） ,46patiants were operated after 8 hours but within 24 hours（early group）and 41 patients were operated after 24hours（late group）. A comparative analysis of rebleeding incidence, recovery of neurological function and mor- tality were conducted. Results High post-operative rebleeding rate and better recovery appeared in ultra-early group （P〈 0.05） ,which superior to the other two group. Significant difference were not found in motality rate （P〉0.05）in three group. Conclusion Ultra-early surgical removal of the hematoma may reduce postoperative neurological deficit and improve thequality of patients ＇ life. Increasing blood pressure to find out bleeding vessel during operation and effective hemostasis , andeffective blood pressure control were beneficial factor to reduce rebleeding rate in ultra-early group.