双管引流治疗高血压脑出血首次血肿清除量及穿刺时机选择(1)
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[摘要] 目的：探讨一次性血肿穿刺针引流治疗高血压脑出血首次血肿清除量及穿刺时机。方法：根据患者发病至穿刺时间，将患者分组，比较各组患者预后、首次血肿清除率、再出血发生率、术后14 d GCS评分。结果：发病至穿刺时间<4 h者20例，4～7 h者64例，7～24 h者78例，>24 h者38例。四组间术后14 d GCS评分差异有统计学意义(χ2=4.52，P=0.002)，发病至穿刺时间<4 h组与发病至穿刺时间4～7 h组两组间比较差异无统计学意义(P>0.05)。再出血发生率发病至穿刺时间<4 h组明显高于其余各组(P<0.05)。发病到穿刺时间<7 h患者的预后良好者明显高于>7 h患者，重残及死亡率明显低于>7 h患者，差异有统计学意义(P<0.05)。结论：侧脑室与血肿同时放置一次性血肿穿刺针引流，能有效治疗高血压脑出血，穿刺的最佳时机为脑出血4～7 h内。
[关键词] 双管引流；高血压；脑出血；穿刺；时机
[中图分类号] R743.34 [文献标识码]A[文章编号]1674-4721(2011)04(b)-027-02
Double-tube drainage in the treatment of hypertensive cerebral hemorrhage volume and hematoma puncture the first timing
REN Xiang1, ZHOU Wensheng2
Mawangdui Hospital of Hunan Province, Changsha 410016, China
[Abstract] Objective: To evaluate the one-time hematoma puncture needle treatment of hypertensive cerebral hemorrhage volume and hematoma puncture the first time. Methods: According to the puncture time of onset, the patient group, the prognosis of patients in each group, the first hematoma rate, rebleeding rate, after 14 days GCS score. Results: The onset to needle time <4 hours in 20 cases, 4 to 7 hours 64 patients, 7 to 24 hours 78 patients, > 24 hours in 38 cases. Among the four groups after 14 days GCS score difference was statistically significant (χ2 = 4.52, P=0.002), onset to needle time <4 hours group and the onset to needle time 4 to 7 hours group difference between the two groups was not statistically significance (P>0.05). Rebleeding rate of onset to needle time <4 hours was significantly higher than other groups (P<0.05). Onset to needle time <7 hours in patients with good prognosis was significantly higher than that of> 7 hours in patients with severe disability and mortality was significantly lower than the> 7 hours in patients, the difference was statistically significant (P<0.05). Conclusion: The lateral hematoma at the same time one hematoma puncture needle placement can be effective in treating hypertensive cerebral hemorrhage, puncture the best time for the cerebral hemorrhage within 4 to 7 hours ......
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