基层医院重症高血压脑出血患者手术时机的选择及方式分析(1)
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[摘要] 目的 分析手术时机的选择以及方式的选择在治疗重症高血压脑出血患者时的治疗效果。方法 回顾分析我院2005年1月-2010年12月治疗过的54例重症高血压脑出血患者的临床资料。根据发病起至手术之间间隔的时间分为三组，超早期手术组患者20例，间隔时间≤7h，早期手术组患者19例，间隔时间为8h-24h，延迟手术组患者15例，间隔时间≥24h，根据患者的脑出血量、出血部位以及血肿是否破入脑室等患者的情况选择手术方式，手术方法有开颅血肿清除并去骨瓣减压术、小骨窗开颅血肿清除术、单侧或双侧脑室外引流术。术后对患者的恢复情况以及生活能力等进行随访。结果 I组患者和Ⅱ组患者比，P﹤0.05，差异有显著性，说明超早期手术优于早期手术，Ⅱ组患者和Ⅲ组患者相比，P﹤0.05，差异有显著性，说明早期手术优于延迟手术。结论 基层医院选择合适的手术方式以及尽量早期进行手术治疗是治疗重症高血压脑出血的关键。
[关键词] 重症高血压； 脑出血； 手术时机； 方式
[中图分类号] R743.34 [文献标识码] A [文章编号] 1005-0515(2011)-12-021-01
[Abstract] Objective Analysis of operation time selection, and selection of surgical methods in treatment of severe hypertensive cerebral hemorrhage treatment effects. Methods Retrospective analysis of our January 2005 -2010 years in December for treatment of 54 cases of severe hypertensive cerebral hemorrhage in patients with clinical data. According to the interval time between onset occurred until the operation is divided into three groups, 20 cases of patients with ultra-early operation groups, time interval ≤7h, 19 cases of early surgical group, interval of 8h-24h, 15 cases of delayed surgery group, time interval ≥24h, On the patient's brain hemorrhage, bleeding and haematoma parts are broken into a computer room, choose surgery patients with surgical methods, there are open-skull hematomas cleared and boneless flap decompression surgery, small bone window open intracranial hematoma removal, single side or double side outdoor drips brain surgery. Recovery and daily living in patients with postoperative follow-up. Results I and Ⅱ group patients unit patients, p﹤0.05, differences of significance stating early surgery better than early operation, Ⅱ and Ⅲ group patients unit patients compared to p﹤0.05, differences are significant, description of early surgery better than delayed surgery. Conclusion Choose appropriate methods, as well as early as possible in the primary hospital for surgical treatment is the key to treatment of severe hypertensive cerebral hemorrhage.
[Key words] Severe hypertensive; Cerebral hemorrhage; Timing; Modes
重症高血压脑出血是指经过检查脑出血量大于50ml[1]或者对患者进行格拉斯哥评分小于8分[2]，其死亡率很高，可以高达90%[3]以上。我院2005年1月-2010年12月曾应用不同的手术时机以及不同的手术方式治疗过54例重症高血压脑出血患者，现将其治疗情况报告如下： ......
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