目的 探讨高血压脑出血(HICH)不同手术时机与患者预后及生存质量的关系.方法 选择2013年1月至2016年6月期间在中国人民解放军南京军区福州总医院神经外科手术治疗的124例HICH患者为研究对象,根据手术时机的不同将出血至手术时间<6 h者60例纳入超早期组,6～24 h者64例纳入早期组,比较两组患者术后再出血率以及随访3个月时患者格拉斯哥预后评分(GOS)优良率、死亡率,并采用WHO生存质量评估简表(WHOQOL-BREF)评价患者生存质量.结果 超早期组与早期组患者术后再出血率分别为8.33％和6.25％,差异无统计学意义(P>0.05);术后随访3个月时,超早期组与早期组患者的死亡率分别为13.33％和15.63％,差异无统计学意义(P>0.05),但是超早期组患者的GOS预后评分优良率为78.33％,明显高于早期组的62.50％,差异有统计学意义(P<0.05);超早期组WHOQOL-BREF评分为(64.3±20.4)分,明显高于早期组的(53.7±18.1)分,差异有统计学意义(P<0.05).结论 对有手术适应证的高血压脑出血患者,超早期手术可有效改善患者的近期预后,提高其生存质量.%Objective To investigate the relationship between the timing of surgery and prognosis and quality of life in patients with hypertensive intracerebral hemorrhage (HICH). Methods A total of 124 patients with HICH, who admitted to Department of Neurosurgery of our hospital from January 2013 to June 2016, were selected and divid-ed into the ultra-early group (<6 h, n=60) and the early group (6～24 h, n=64) according to the different timing of sur-gery. The postoperative rebleeding rate and the excellent rate and mortality of Glasgow outcome score (GOS) for fol-low-up of 3 months in the two groups were compared, and WHOQOL-BREF score was used to evaluate the life quali-ty. Results There was no significant difference in the postoperative rebleeding rate between the ultra-early group (8.33％) and the early group (6.25％) (P>0.05);after 3 months of follow-up, there was still no difference in the mortality between the ultra-early group (13.33％) and the early group (15.63％) (P>0.05). However, the GOS score excellent rate in the ultra-early group was 78.33％, which was significantly higher than 62.50％of the early group (P<0.05);the WHO-QOL-BREF score in the ultra-early group was (64.3±20.4), which was significantly higher than (53.7±18.1) in the con-trol group (P<0.05). Conclusion For patients with hypertensive cerebral hemorrhage who have indications of opera-tion, the ultra-early operation can effectively improve the short-term prognosis and the quality of life.
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