高血压脑出血术后再出血的原因分析  

Clinical analysis of postoperative rebleeding after surgery for hypertensive intracranial hemorrhage

作　　者：王贤[1] 陈罡[2] 葛志强[2] 时飞[2] 

机构地区：[1]金坛市人民医院脑外科,213200 [2]苏州大学附属第一医院神经外科

出　　处：《临床神经外科杂志》2015年第1期66-68,共3页Journal of Clinical Neurosurgery

摘　　要：目的探讨高血压脑出血术后再出血的原因及对策。方法回顾性分析2003年8月-2012年8月在苏州大学附属第一医院行高血压脑出血手术治疗的712例患者的临床资料,采用X2检验对各原因进行单因素分析。结果术后2周内46例患者发生再出血,再出血率为6.46%,其中87%的患者术后再次出血发生在术后48 h内。凝血功能异常、高血压病程大于10年、血肿位于小脑、超早期手术及术后血压剧烈波动是术后再出血危险因素。结论积极纠正凝血异常患者凝血指标,掌握合适手术时机,术中严密止血,术后加强监护,维持血压平稳是控制术后再出血关键。Objective To explore the causes of rebleeding after hypertensive intracranial hemorrhage surgery and find the prevention and treatment methods of it .Methods The clinical date of 712 patients with hypertensive intracranial hemorrhage were underwent the operation in our hospital from August 2003 to August 2012 were analyzed retrospectively .The chi square test was used to analysis the causes of rebleeding .Results 46 patients experienced postoperative rebleeding in 2 weeks,accounting for 6.46%.87%postoperative rebleeding happened within 48 hours. Abnormal blood coagulation function after surgery , history of hypertension more than 10 years,hemorrhage located in the cerebellar ,ultra-early surgery ,sudden rise in blood pressure were important causes of rebleeding .Conclusion It is important to prevent rebleeding by correcting blood coagulation function , proper opportunity for surgery , intraoperative careful hemostasis ,intensive care and maintain a stable blood pressure after surgery .

关 键 词：高血压脑出血 术后再出血 危险因素 

分 类 号：R651.1[医药卫生—外科学]