高血压性脑出血微创术后继续出血危险因素分析  

Risk factors for minimally invasive postoperative bleeding of hypertensive intracranial hemorrhage

作　　者：郭仕峰 郝培来 薛彦忠 李秀秀 庄肃敬 

机构地区：[1]山东省沂水中心医院,山东临沂276400

出　　处：《山东医药》2012年第36期42-44,50,共4页Shandong Medical Journal

摘　　要：目的探讨影响高血压性脑出血(ICH)微创血肿穿刺引流术后继续出血的危险因素。方法选取在我院神经内科诊断为脑出血,行微创血肿穿刺引流术的患者98例,按术后有无继续出血分为两组,病例组为术后继续出血的患者20例,对照组为术后无继续出血的患者78例,利用SPSS软件对临床资料进行统计学分析。结果①病例组ICH Score、GGT、收缩压(SBP)、血糖(GLU)、每日饮酒量、原发出血量较对照组增高,FIB较对照组降低,P<0.05或<0.01;病例组ALT、AST、舒张压(DBP)、CH、TG、LDL较对照组增高,病例组HDL较对照组降低(P>0.05)。②病例组发病到手术的时间短于对照组(P<0.01)。③病例组血肿形态不规则者高于对照组(P<0.05)。④病例组手术前后躁动不安者较对照组增高(P<0.05)。⑤Spearman’s秩相关分析显示,术后继续出血与ICHScore、GGT、SBP、每日饮酒量、原发出血量、手术前后躁动呈正相关,与发病到手术的时间、血肿形态、FIB呈负相关(P<0.05或<0.01),与GLU无相关性。结论发病后6 h内施行手术、手术前后躁动、术前血压增高、长期酗酒、肝功能异常、低纤维蛋白原水平和血肿形态不规则为微创颅内血肿穿刺术术后继续出血的危险因素。Objective To explore the impact of risk factors for postoperative bleeding in minimally invasive hematoma puncture of hypertensive intraeerebral hemorrhage （ICH）. Methods A total of 98 patients treated by minimally invasive hematoma puncture were included in the research. All patients after surgery were divided into two groups by bleeding or whether. 20 patients with continue bleeding after surgery was the case group, the control group was the 78 patients without bleeding. Clinical data of patients were statistically analyzed by using SPSS statistical analysis software. Results ①ICH Score, GGT, systolic blood pressure （SBP） , glucose （GLU） , daily alcohol consumption and the original issued amount of blood were higher than those in the control group, but the FIB were decreased, P 〈0.05 or P 〈0.01. ALT and AST and diastolic blood pressure （DBP） , CH, TG and LDL in the ease group were increased compared with the control group, HDL in the case group was decreased （ P 〉 0. 05 ）. ② Time of onset to surgery time in case group was shorter than the control group （P 〈0.01 ）. ③Hematoma irregular shape in case group was higher than that in the control group （P 〈0.05 ）. ④ Restless patient in case group was increased than that in the control group （ P 〈 0.05 ）. ⑤Postoperative bleeding was posi- tive correlated with ICH score, GGT, SBP, daily alcohol consumption, the original issued amount of blood by analyzed by Spearman＇ s rank correlation analysis. Postoperative bleeding was negative correlated with onset to surgery time, hematoma form, FIB, no correlaiton with GLU. Conclusions Postoperative bleeding in patients given minimally invasive intracranial hematoma puncture is related especially with puncture within 6 hours, the increased SBP and restlessness before and after surgery. While patients with chronic alcoholism, abnormal liver function or low fibrinogen levels are probability of postoperative bleeding.

关 键 词：微创穿刺手术 高血压性脑出血 继续出血 危险因素 

分 类 号：R741[医药卫生—神经病学与精神病学]