前瞻性研究脑室内出血的临床报告  

An arospective clinical study of intraventricular hemorrhage

作　　者：李浩[1] 陈礼刚 唐晓平[3] 方媛[1] 昝昕[1] 董薇[1] 林森[1] 王昆[1] 傅敏[1] 游潮[1] 

机构地区：[1]四川大学华西医院神经外科,成都610041 [2]泸州医学院附属医院神经外科 [3]川北医学院附属医院神经外科

出　　处：《中华神经外科杂志》2013年第4期330-334,共5页Chinese Journal of Neurosurgery

基　　金：国家十二五科技支撑计划项目课题（2011BA108B05）

摘　　要：目的了解四川地区脑室内出血（IVH）的影响因素、病因、危险因素等，为IVH的临床研究提供依据。方法采用前瞻性队列研究，以四川省3家三甲医院的住院患者为基础，进行多中心协作登记，收集包括人口学因素、IVH的危险因素、临床表现、辅助检查结果等数据。结果纳人IVH患者660例，男416例（63．0％），女244例（37．0％）；年龄17—93岁，平均（60．4±13．8）岁；原发性脑室内出血（PIVH）中高血压病31例（31．3％）、动脉瘤13例（13．1％）、血管畸形18例（18．2％）、烟雾病24例（24．2％）和未知病因13例（13．1％）；而继发性脑室内出血（SIVH）中高血压病为391例（69．7％）、未知病因162例（28．9％）、动脉瘤、血管畸形和脑淀粉样血管病分别有3例（0．5％）、3例（0．5％）和2例（0．4％）；入院时PIVH和SIVH组间GCS评分差异有统计学意义，P〈0．05；PIVH组47例（47．5％）手术治疗、32例（32．3）保守治疗，18例（18．2％）伽马刀治疗，另有2例（2．0％）介入治疗；SIVH组手术、保守和介入治疗分别是175例（31．2％）、383例（68．3％）和3例（0．5％），手术、保守和伽马刀治疗组间差异有统计学意义，P〈0．05；多因素Logistic回归分析提示年龄、高血压是发生SIVH的独立危险因素。结论本研究在国内外同类研究中样本量最大，研究质量较高，结论可靠，为IVH的临床研究设计提供了理论依据。Objective To fully understand influencial factors, etiology and risk factors of IVH in Sichuan province for providing evidence and establishing foundation for the future clinical research on measures of prevention and cure of IVH. Methods This study included patients from 3 Third grade hospitals of Sichuan province based on collaborative multi-center registration of stroke patients. Data collection in IVH patients, including demographic factors, risk factors, clinical manifestations, and auxiliary examination reports. Data were inserted, managed and statistically treated and analysed using PASW For Windows 18.0 software pakage. Results Altogether 660 hospitalized IVH patients fulfilling the inclusion criteria were consequetively registered in the three study centre. Among them, 416 cases （63.0%） were male and 224 cases （37.0%） were female. Age ranged from 17 to 93 years with a mean age of 60. 4± 13.8 years. Causes of PIVH included hypertension in 31 patients （31.3%）, aneurysm in 13 cases （ 13.1% ） , vascular malformations in 18 cases （18.2%） ,moyamoya disease in 24 patients （24. 2% ） and idiopathic in 13 cases （ 13.1% ）. While causes of SIVH included hypertension in 391 patients （69.7%）, idiopathic in 162 patients （ 28. 9% ） , aneurysms in 3 cases （0. 5% ） , vascular malformations in 3 cases （0. 5% ） and cerebral amyloid angiopathy 2 cases （0. 4% ）. There was significant difference in GCS score distribution during admission between PIVH and SIVH, P 〈 0. 05. IVH scores between groups was not statistically different. In PIVH： 47 cases （47.5%） underwent surgery, 32 cases （32.3%） had conservative management, 18 cases （ 18.2% ） had GKS and 2 cases （2.0%） had endovascular intervention. While in SIVH： 175 cases （31.2%） underwent surgery,383 cases （68.3%） had conservative management and 3 cases （ 0. 5% ） had endovascular intervention. There was statistical significance between groups having surgical, conservative and GKS management, P 〈

关 键 词：脑室内出血 临床研究 前瞻性 病因学 危险因子 

分 类 号：R743.34[医药卫生—神经病学与精神病学]