PDF(Pubmed)
Abstract：
BACKGROUND: Intracerebral hemorrhage is a high-risk pathological event that is associated with formidable morality rates. Here, our objective was to perform a retrospective study to determine the best timing for drainage using physiological data on patients who received drainage at different timings.
METHODS: In this retrospective study, we reviewed 198 patients with hypertensive cerebral hemorrhage who underwent stereotactic drainage at the conventional timing (surgery within 12 h of admission; control group) and 216 patients who underwent stereotactic drainage at a customized surgical timing (elective group). Follow-ups were performed at 3 and 6 months after surgery.
RESULTS: The clinical indicators, including prognosis, hematoma clearance, recurrent hemorrhage, intracerebral infection, pulmonary infection, deep venous thrombosis, gastrointestinal hemorrhage, National Institutes of Health Stroke Scale scores, and matrix metallopeptidase 2 and 9 levels, were compared between the control and elective groups. Our data indicated that the elective group had significantly better prognosis compared to the control group (p = 0.021), with a higher rate of hematoma clearance (p = 0.004) and a lower rate of recurrent hemorrhage (p = 0.018). The total occurrence rate of post-surgery complications was also lower for the elective group (p = 0.026). NIHSS scores and serum MMP2/9 levels of the elective group were lower than those of the control group.
CONCLUSIONS: Customized timing of stereotactic drainage may be superior to conventional fixed timing (within 12 h post-hemorrhage) in reducing post-surgery complications and promoting recovery, which supports the potential use of customized timing of stereotactic minimally invasive drainage as a new convention in clinics.
METHODS: In this retrospective study, we reviewed 198 patients with hypertensive cerebral hemorrhage who underwent stereotactic drainage at the conventional timing (surgery within 12 h of admission; control group) and 216 patients who underwent stereotactic drainage at a customized surgical timing (elective group). Follow-ups were performed at 3 and 6 months after surgery.
RESULTS: The clinical indicators, including prognosis, hematoma clearance, recurrent hemorrhage, intracerebral infection, pulmonary infection, deep venous thrombosis, gastrointestinal hemorrhage, National Institutes of Health Stroke Scale scores, and matrix metallopeptidase 2 and 9 levels, were compared between the control and elective groups. Our data indicated that the elective group had significantly better prognosis compared to the control group (p = 0.021), with a higher rate of hematoma clearance (p = 0.004) and a lower rate of recurrent hemorrhage (p = 0.018). The total occurrence rate of post-surgery complications was also lower for the elective group (p = 0.026). NIHSS scores and serum MMP2/9 levels of the elective group were lower than those of the control group.
CONCLUSIONS: Customized timing of stereotactic drainage may be superior to conventional fixed timing (within 12 h post-hemorrhage) in reducing post-surgery complications and promoting recovery, which supports the potential use of customized timing of stereotactic minimally invasive drainage as a new convention in clinics.
摘要：
背景：脑出血是一种高风险的病理事件，与高死亡率相关。这里,我们的目的是进行一项回顾性研究,利用不同时间接受引流的患者的生理数据,确定引流的最佳时机.
方法：在这项回顾性研究中，我们回顾了198例高血压脑出血患者在常规时机接受立体定向引流(入院12h内手术;对照组)和216例患者在定制手术时机接受立体定向引流(择期组).术后3个月和6个月进行随访。
结果：临床指标，包括预后，血肿清除,复发性出血,脑内感染,肺部感染,深静脉血栓形成,消化道出血,美国国立卫生研究院卒中量表评分,和基质金属肽酶2和9水平，在对照组和选修课之间进行比较。我们的数据表明，与对照组相比，选择性组的预后明显更好（p=0.021）。血肿清除率较高（p=0.004），再出血率较低（p=0.018）。择期组术后并发症的总发生率也较低（p=0.026）。择期组NIHSS评分及血清MMP2/9水平均低于对照组。
结论：立体定向引流的定制时机在减少术后并发症和促进康复方面可能优于常规固定时机（出血后12小时内）。这支持立体定向微创引流的定制时机的潜在使用，作为临床上的新惯例。
方法：在这项回顾性研究中，我们回顾了198例高血压脑出血患者在常规时机接受立体定向引流(入院12h内手术;对照组)和216例患者在定制手术时机接受立体定向引流(择期组).术后3个月和6个月进行随访。
结果：临床指标，包括预后，血肿清除,复发性出血,脑内感染,肺部感染,深静脉血栓形成,消化道出血,美国国立卫生研究院卒中量表评分,和基质金属肽酶2和9水平，在对照组和选修课之间进行比较。我们的数据表明，与对照组相比，选择性组的预后明显更好（p=0.021）。血肿清除率较高（p=0.004），再出血率较低（p=0.018）。择期组术后并发症的总发生率也较低（p=0.026）。择期组NIHSS评分及血清MMP2/9水平均低于对照组。
结论：立体定向引流的定制时机在减少术后并发症和促进康复方面可能优于常规固定时机（出血后12小时内）。这支持立体定向微创引流的定制时机的潜在使用，作为临床上的新惯例。
