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目的探讨高血压脑出血(HICH)微创穿刺术围手术早期(从决定手术至术后24 h内)预防再出血的策略和安全性。方法对绵阳富临医院神经外科2004年3月至2014年12月233例高血压脑出血病例在微创穿刺术围手术早期采取两种不同的策略预防再出血,对比二者的再出血率、死亡率。结果两组患者的出血部位及出血量差异均无统计学意义(P>0.05)。策略一组的117例患者再出血33例,占28.20%,死亡37例,占31.62%;策略二组的116例患者再出血10例,占8.62%,死亡15例,占12.93%,策略二组的再出血率和死亡率均低于策略一组,差异有统计学意义(P<0.01)。结论高血压脑出血微创穿刺术围手术早期术中全麻+术后镇痛镇静的策略平稳安全,可以降低再出血率和死亡率。
Objective To investigate the strategy and safety of percutaneous transhepatic hemorrhage (HICH) minimally invasive perioperation for the prevention of rebleeding in the early stage (from the time of decision surgery to 24 hours after operation). Methods Twenty-three patients with hypertensive intracerebral hemorrhage from March 2004 to December 2014 in Mianyang Fulin Hospital were enrolled in this study. Two different strategies were used to prevent hemorrhage at the early stage of minimally invasive surgery. The rate of rebleeding, mortality rate. Results There were no significant differences in bleeding sites and bleeding between the two groups (P> 0.05). In the strategy group, 117 patients rebleeded in 33 cases (28.20%) and 37 died (31.62%). In the second group, 116 patients rebleeded in 10 cases (8.62%) and 15 died (12.93%). Strategy 2 The rebleeding rate and the mortality rate in the group were lower than those in the strategy group, with statistical significance (P <0.01). Conclusion Hypertensive intracerebral hemorrhage minimally invasive perioperative perioperative early postoperative general anesthesia + postoperative analgesic sedation strategy safe and safe, can reduce the rate of rebleeding and mortality.