Abstract: Objective To analyze the clinical characteristics and treatment experience of the patients with coronavirus disease 2019 (COVID-19) and hemorrhagic cerebrovascular disease. Methods The data of patients with COVID-19 and hemorrhagic cerebrovascular disease from 6 hospitals in Wuhan between January 13, 2020 and March 13, 2020 were retrospectively analyzed. The clinical characteristics and treatment of the patients were described, and the clinical characteristics and postoperative tracheotomy rate were compared between the patients with hypertensive intracerebral hemorrhage who received minimally invasive treatment and craniotomy. Results A total of 82 patients, aged 43-78 years and 40 men (48.78%), were included in the

study. There were 37 cases (45.12%) with mild pneumonia and 45 cases (54.88%) with severe

pneumonia; 56 cases (68.29%) with hypertensive cerebral hemorrhage, 25 cases (30.49%) with ruptured intracranial aneurysm hemorrhage, 1 cases (1.22%) with hemorrhagic moyamoya disease. 59 patients (71.95%) received surgical treatment for cerebral hemorrhage, including 38 patients (64.41%) with hypertensive cerebral hemorrhage, 21 patients (35.59%) with ruptured intracranial aneurysms, and 31 patients (52.54%) with tracheotomy. For the patients with hypertensive intracerebral hemorrhage, 15 cases (39.47%) in craniotomy group and 23 cases (60.53%) in minimally invasive surgery group. There were no statistically significant differences in age, gender distribution, severity of pneumonia and GCS score between the two groups, but the ratio of postoperative tracheotomy in craniotomy group was higher than that in minimally invasive surgery group (93.33% vs 30.43%, P <0.001). Conclusions For the patients with COVID-19 and hypertensive intracerebral hemorrhage requiring surgical treatment, the ones who received minimally invasive surgery had a lower tracheotomy rate than those who received craniotomy.

Key words: Novel coronavirus; Pneumonia; Cerebrovascular disease; Tracheotomy;Endotracheal intubation; Clinical characteristics

摘要： 目的 分析2019冠状病毒病（coronavirus disease 2019，COVID-19）合并出血性脑血管病患者的临床 特点及治疗经验。 方法 回顾性分析2020年1月13日-3月13日武汉市6家医院连续收治的COVID-19且合并出血性脑血管 病患者的临床资料，描述患者临床特点和治疗经验，比较高血压脑出血患者中行微创治疗和开颅手 术治疗患者的临床特点和术后气管切开率。 结果 研究共纳入82例患者，年龄43～78岁，男性占48.78%（40/82）。轻型肺炎45.12%（37/82），重 症肺炎54.88%（45/82）；高血压脑出血占68.29%（56/82），颅内动脉瘤破裂出血30.49%（25/82）， 出血性烟雾病1.22%（1/82）；71.95%（59/82）的患者进行了针对脑出血的手术治疗，其中高血压脑 出血患者64.41%（38/59），颅内动脉瘤破裂35.59%（21/59），术后气管切开者52.54%（31/59）。高 血压脑出血患者中，开颅手术组15例（39.47%），微创手术组23例（60.53%），两组的年龄、性别分 布、肺炎严重程度和GCS评分差异均无统计学意义，但开颅手术组术后气管切开率高于微创手术组 （93.33% vs 30.43%，P＜0.001）。 结论 COVID-19合并高血压脑出血且需要手术治疗的患者，选择微创手术较开颅手术的气管切开率 更低。

关键词: 新型冠状病毒; 肺炎; 脑血管病; 气管切开术; 气管插管; 临床特点