中华灾害救援医学

目的 探讨分析手术时机对创伤性脑出血患者预后的影响。方法 纳入漳州第三医院神经外科2019年9月至2024年12月收治的104例创伤性脑出血患者，以随机数字表法分为对照组、观察组，每组52例，对照组实施初始保守治疗，观察组采用早期手术治疗；对两组患者预后情况、昏迷与神经缺损评分、并发症发生率、死亡率比较分析。结果 观察组预后表现为Ⅳ级、Ⅴ级的患者数量高于对照组，差异有统计学意义（P<0.05）。干预前昏迷与神经缺损评分未见差异（P > 0.05），干预后观察组GCS高于对照组，观察组NIHSS低于对照组，差异有统计学意义（P<0.05）。观察组并发症发生率、死亡率均低于对照组，差异有统计学意义（P<0.05）。结论 对于创伤性脑出血患者，为其提供不同手术治疗时机，其中接受早期手术治疗的患者其预后效果更理想，患者神经功能得到更显著改善，降低并发症与死亡概率。

Objective To investigate the impact of surgical timing on the prognosis of patients with traumatic intracranial hemorrhage. Methods A total of 104 patients with traumatic intracranial hemorrhage admitted to the Department of Neurosurgery at Zhangzhou Third Hospital from September 2019 to December 2024 were enrolled and randomized by a random number table into a control group and an early-surgery group(n=52 each). The control group received initial conservative management, while the early-surgery group underwent early surgical intervention. Functional outcomes, levels of consciousness and neurological deficit scores, complication rates, and mortality were compared between groups. Results The number of patients achieving outcome grades IV–V was higher in the early-surgery group than in the control group(P<0.05). There were no between-group differences in Glasgow Coma Scale(GCS) and National Institutes of Health Stroke Scale(NIHSS) scores before intervention(P>0.05). Post-intervention, GCS was higher and NIHSS was lower in the early-surgery group compared with the control group(both P<0.05). The incidence of complications and the mortality rate were both lower in the early-surgery group than in the control group(both P<0.05). Conclusion Among patients with traumatic intracranial hemorrhage, earlier surgical intervention is associated with more favorable clinical outcomes, greater improvement in neurological function, and reduced risks of complications and death.