高血压脑出血手术后再出血相关因素分析（附18例报告）  

Relative Factor Analysis on Recurrent Hemorrhage After Operation of Hypertensive lntracerebral Hemorrhage （ a report of 18 cases）

作　　者：陶玉铭[1] 张齐刚[1] 孙茂琦[1] 孙建国[1] 韩跃彬[1] 

机构地区：[1]安徽省蚌埠市第一人民医院神经外科,233000

出　　处：《解剖与临床》2009年第4期259-261,共3页Anatomy and Clinics

摘　　要：目的：探讨高血压脑出血（HICH）术后再出血的原因及对策。方法：2004年1月～2008年4月手术治疗HICH104例中，术后再出血18例；分析术后再出血相关因素。结果：本组术后再出血发生率17．30％。初次手术于HICH24h内实施者36例，术后再出血10例（27．78％），初次手术于HICH24h以上实施者68例，术后再出血8例（11．76％），两者比较差异有统计学意义（P〈0．05）。术后原发出血部位再出血11例、非原发部位再出血7例；初次手术中止血困难8例中，术后再出血4例（50．00％）；术后血压波动6例中再出血4例（66．67％）。结论：影响HICH术后再出血的因素很多、机制复杂；合理选择手术时机、术中彻底止血、术后控制血压和颅内压，对防止术后再出血、降低死亡率有积极意义。Objective：To investigate the cause and therapeutic regimen of rehaemorrhagia after operations of hypertensive cerebral hemorrhage （HICH）. Methods： 104 cases accepted operations for treating HICH from 2004 to 2008, out of them 14 suffered from postoperative rehaemorrhagia. The con＇elation factors were analyzed. Results： The rate of postoperative rehaemorrhagia was 17.30%. Thirty-six cases received operation within 24 hours of HICH, and the rehaemorrhagia occurred in 10 cases （27.78%）. 68 cases accepted operation after 24 hours of HICH, and eight cases （ 11.76% ） happened postoperative rehaemorrhagia. There was significant difference in the incidence of rehaemorrhagia between two groups （ P 〈 0.05 ）. Eleven cases of rehaemorrhagia happened at o- riginal places, seven at other places instead of their original places. In primary operation, 8 cases had difficulties to stop bleeding, four of which got postoperative rehaemorrhagia （50.00%）. Four of eight patients with blood pressure undulating after operation suffered from postoperative rehaemorrhagia（ 66.67% ）. Conclusions： Many causes result in postoperative rehaemorrhagia after HICH with complex mechanism. That choosing the operative opportunity, stopping bleeding completely, controlling blood pressure and intracranial pressure, has a positive significance for avoiding the postoperative rehaemorrhagia and reducing the mortality.

关 键 词：高血压脑出血 手术 再出血 相关因素 

分 类 号：R651.12[医药卫生—外科学]