Abstract:ObjectiveTo study the clinical effect of different timing and surgical methods in the treatment of hypertensive intracerebral hemorrhage and analyze its applicability.MethodsFrom January 2012 to January 2016,301 patients with hypertensive intracerebral hemorrhage admitted into our hospital were selected as study objects and divided into three groups,super-early treatment group (<6 h,n=81),early treatment group (6-24 h;n=156),and late treatment group(>24 h;n=64)according to different timing (time from disease attack to hospitalization for treatment).Based on the bleeding position,amount of hemorrhage and degree of hematoma during the treatment,different surgical methods groups were selected,there were 92,121,and 88 cases in decompressive hematoma evacuation group,small bone window craniotomy group and puncture drainage group.The therapeutic effects in different time and surgical methods were compared.ResultsThe excellent rate in the supev-early treatment group,early treatment group and late treatment group was 77.8%,50.0%and 35.9%in a short term,and the rate of favorable prognosis during followed-up visits was 72.8%,56.4% and 31.2%,the rate in the super-early treatment group was superior to that in the early treatment group and the late treatment group,and the early treatment group was superior to that in the late treatment group with statistical difference (P<0.05).The incidence of complications decompressive hematoma evacuation group,small bone window craniotomy group and puncture drainage group was 40.2%,24.8%,and 10.2%.The incidence of complications in the decompressive hematoma evacuation group was the highest,and the incidence in the puncture drainage group was the lowest with statistical difference after comparison(P<0.05).The incidence of rehaemorrhagia in these three groups was 8.7%,7.4%,and 10.2%respectively,which was not displayed significant difference(P>0.05).ConclusionFor patients meeting the surgical procedures,early implementation of surgical treatment can effectively improve neurological function and obtain a good prognosis.The selection of surgical methods should comprehensively consider patients′disease condition and physical state in order to decrease the incidence of complications and promote the quality of life in prognosis.
黄坚. 不同时机和手术方式在高血压脑出血治疗中的应用与临床适用性研究[J]. 中国当代医药, 2016, 23(35): 55-58.
HUANG Jian. Application and clinical applicability of different timing and surgical methods in the treatment of hypertensive intracerebral hemorrhage. 中国当代医药, 2016, 23(35): 55-58.
Broderick JP,Adams HP Jr,Barsan W,et al.Guidelines for the management of spontaneous intracerebral hemorrhage Guidelines for the management of spontaneous intracerebral hemorrhage:a statement for healthcare professionals from a special writing group of the Stroke Council,American Heart Association[J].Stroke,1999,30(4):905-915.
Montes JM,Wong JH,Fayad PB,et al.Stereotactic computed tomography-guided aspiration and thrombolysis of intracerebral hematoma:protocol and preliminary experience[J]. Stroke,2000,31(4):834-840.