高血压脑出血立体定向血肿引流术预后的相关因素分析  

Analysis of the relevant elements of influencing prognosis of stereotactic evacuation on hypertensive cerebral hemorrhage

作　　者：荣道建[1] 张海波[1] 赵俊伟[1] 吴玉平[1] 于洋[1] 王刚[1] 张浩[1] 

机构地区：[1]沈阳医学院附属奉天医院神经外科,沈阳110024

出　　处：《立体定向和功能性神经外科杂志》2010年第4期229-231,共3页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的分析影响立体定向血肿抽吸引流术治疗高血压脑出血患者预后的因素。方法三维重建单(双)靶点定向置管引流术治疗幕上高血压脑出血患者215例,将患者的临床资料和随访资料进行分析,经单因素模型分析术后1个月内患者死亡的影响因素,采用Logistic多变量逐步回归分析确定影响手术预后的主要因素。结果患者术后1个月内出现严重并发症共70例(32.6%),其中颅内感染8例、血肿增加17例、应激性道溃疡19例及肺部感染26例,患者术后1个月内共死亡17例(7.9%)。血肿破入脑室、血肿增加、肺部感染及应激溃疡为患者术后1个月内死亡的主要危险因素。结论立体定向血肿抽吸引流术后应该重点防治血肿增加、肺部感染及应激性溃疡,以便改善高血压脑出血患者手术的预后。Objective To analyze the risk factors of influencing the prognosis of the patients with hypertensive cerebral hemorrhage treated by stereotactic aspiration and thrombolysis.Methods Two hundred and fifteen patients with supratentorial hypertensive cerebral hemorrhage were treated by 3-D rebuilding guidance stereotactic aspiration with single or double tubes and thrombolysis.The clinical and following up data of all the patients were analyzed.The model of single factor was employed to analyze the factors influencing 30d mortality after the operation and then logistic gradual regressive analysis of the major risk factors was performed.Results The patients have 70 cases（32.6%） of serious complications in 30 days after the operation,8 cases of encephalic infection,17 cases of hematoma enlargement,19 cases of stress ulcer and 26 cases of pulmonary infection.The total amount of death is 17 cases（7.9%） in 30 days after the operation.Hematoma spreading to ventricle,Hematoma enlargement,pulmonary infection and stress ulcer are the major risk factors of influencing 30d mortality after the operation.Conclusion We should take measures to avoid hematoma enlargement,pulmonary infection and stress ulcer during stereotactic aspiration and thrombolysis of intracerebral hematoma to improve the prognosis in the patients with hypertensive cerebral hemorrhage.

关 键 词：高血压脑出血 立体定向 危险因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]