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The optimization of time course for surgical treatment of hypertensive intracerebral hemorrhage

WANG Jianqing1, CHEN Xiancheng2, WU Jinsong2, et al 1. Department of Neurosurgery, Minghang Hospital, Shanghai 201100, China; 2. De partment of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China  
Objective To determine the optimal time course for surgical treatment of hypertensive intracerebral hemorrhage. Methods Among all 500 cases of ICH, th ere were 234 cases for medical treatment and 266 cases for surgical treatment. A ccording to the time course after initial onset, they were divided into three gr oups, which were Ultra-early group (≤ 7 h),Early group (7~24 h), and Delay gro up ( 24 h). The near-term outcome (GOS scale), long-term outcome (Barthel scale ), mortality, as well as incidence of associated complications were compared res pectively. Results ①In the Ultra-early and Early groups,both the near-term and long-term outcome of surgical treatment was definitely better than medical treat ment.②For the outcome of surgical treatment, there was no significantly differe nce between Ultra-early and Early groups.③In the Ultra-early group, the risk of recurrent post-operative hemorrhage was higher, and decreased henceforth.④In t he Delay group, the incidence of associated complications of respiratory, urinar y and gastrointestinal system was higher for surgery than medication. Conclusion The early stage (7~24 h) was the optimal time course for surgical treatment of intracerebral hemorrhage.
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