Balasa Adrian, Ghiga Dana, Andone Razvan-Sebastian, Zahan Ancuta Elena, Florian Ioan Alexandru, Chinezu Rares
Department of Neurosurgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Tîrgu Mureș, Romania.
Department of Neurosurgery, Tîrgu Mureș Clinical Emergency County Hospital, 540136 Tîrgu Mureș, Romania.
Brain Sci. 2020 Dec 23;11(1):5. doi: 10.3390/brainsci11010005.
Spontaneous intracerebral hemorrhage (ICH) is a severe form of stroke. The efficacy of surgery as ICH treatment is controversial. We sought to compare the 30-day postoperative mortality rate between patients with surgically and medically treated ICH; Methods: This prospective study enrolled patients consecutively diagnosed with ICH and treated between 2017 and 2019. Patients meeting the study surgical indications were assigned to either surgical or medical treatment. The relationship between Glasgow Coma Scale (GCS) score, age, ICH location, ICH volume, and 30-day mortality was analyzed. Results: A total of 174 ICH patients were enrolled in this study. Of these, 136 met the surgery criteria; 65 of these underwent surgery (Group A), and 71 received medical treatment (Group B). Age and ICH location did not modify mortality. Although surgery did not overall improve mortality some better postsurgical outcomes were observed among patients surgically treated with GCS scores of at least 10 points and ICH volumes between 30 to 50 mL; Despite achieving an immediate reduction in intracranial pressure, surgery seems to be advantageous only for patients with ICH volumes between 30 to 50 mL and GCS scores of 10 points or higher.
自发性脑出血（ICH）是一种严重的中风形式。手术作为ICH治疗方法的疗效存在争议。我们试图比较接受手术治疗和药物治疗的ICH患者术后30天的死亡率；方法：这项前瞻性研究纳入了2017年至2019年期间连续诊断为ICH并接受治疗的患者。符合研究手术指征的患者被分配接受手术治疗或药物治疗。分析了格拉斯哥昏迷量表（GCS）评分、年龄、ICH位置、ICH体积与30天死亡率之间的关系。结果：本研究共纳入174例ICH患者。其中，136例符合手术标准；其中65例接受了手术（A组），71例接受了药物治疗（B组）。年龄和ICH位置并未改变死亡率。尽管手术总体上并未提高死亡率，但在GCS评分至少为10分且ICH体积在30至50 mL之间的接受手术治疗的患者中观察到了一些较好的术后结果；尽管手术能立即降低颅内压，但似乎仅对ICH体积在30至50 mL之间且GCS评分10分或更高的患者有利。
