高血压脑出血患者立体定向治疗后继续出血因素研究  

The research of continuing hemorrhage after stereotactic hematoma

作　　者：张西亭 戴卫星 丁维领 赵秀平 李洪金 

机构地区：[1]山东省东阿县人民医院,252201

出　　处：《实用医技杂志》2010年第7期613-615,共3页Journal of Practical Medical Techniques

摘　　要：目的研究立体定向技术治疗高血压脑出血患者出现继续出血的因素,从而不断规范脑出血的手术治疗方法,提高脑出血手术成功率,降低病死率及致残率。方法前瞻性开放性队列研究,使用的数据常规收集368例我院患者,关于术后继续出血与发病的不同时间(分3个时间段:<6,6～24,>24h)的研究,以及对每个时间段的继续出血的发病率和手术前后发生躁动易出现继续出血等影响因素讨论。结果①随着发病时间的延长,继续出血的发生率下降,有统计学意义P<0.01。②脑出血术后继续出血与收缩压增高有关P<0.01,与舒张压增高无明显关系P>0.05。③手术后躁动是立体定向术后继续出血的主要临床表现P<0.01。④首次血肿清除量≥75%是引起患者术后继续出血,病情加重导致死亡的原因之一P<0.01。结论高血压脑出血立体定向术后继续出血与收缩压增高、手术后躁动、首次血肿清除量≥75%有关。Objective Research on the continuing hemorrhage after Stereotactic treatment of hypertension caused by cerebral hemorrhage,so as to regulate the surgical treatment of cerebral hemorrhage, improve the success rate of operation, reduce mortality and morbidity. Methods Prospective open cohort study using routinely collected data from 368 general practices in our hospital, about the pathogenesis of three different periods： 〈6, 6-24, 〉24 h, the morbidity and the irritation influence on the incidence of hemorrhage occurring in each period after operation. Results （1） With the time lasting, the incidence of bleeding decreases continuely, it＇s statistically significant P〈0.01. （2） Continued hemorrhage after cerebral hemorrhage is related to systolic blood pressure increased P〈0.01, but it is not related to diastolic blood pressure increased P〉0.05. （3）Post-operative agitation is one of the main reasons of bleeding after stereotactic treatment P〈0.01. （4） Initial hematoma volume released t〉 75% is another reason leading to bleeding or to exacerbations to death P〈0.01. Conclusioti Stereotactic treatment of hypertension leading to cerebral hemorrhage is related to systolic blood pressure increased after surgery, agitation,the first evacuation of hematoma volume ≥75% relevant.

关 键 词：颅内出血 高血压性 定向力 继续出血 

分 类 号：R544.1[医药卫生—心血管疾病] R743.3[医药卫生—内科学]