高血压性脑出血手术预后的影响因素分析  

Analysis of factors related to prognoses in patients with hypertensive intracerebral hemorrhage

作　　者：徐兵[1] 雍成明[1] 杨代明[1] XU Bing;RUAN Cheng-ming;YANG Dai-ming(Department of Neurosurgery,Chaohu Hospital Affiliated to Anhui Medical University,Hefei 238000,China)

机构地区：[1]安徽医科大学附属巢湖医院神经外科,合肥238000

出　　处：《中国临床神经外科杂志》2018年第10期662-664,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨手术治疗高血压性脑出血预后的影响因素。方法回顾性分析2014年1月至2017年1月收治的84例手术治疗的高血压性脑出血的临床资料,术后3个月GOS评分3～5分为预后良好,1～2分预后不良。采用多因素Logistic回归检验预后影响因素。结果 84例中,预后良好37例,预后不良47例。多因素Logistic回归分析显示,年龄≥65岁、高血压病史≥10年、术前CGS评分低、出血量≥30 ml和术后并发症≥2种为高血压性脑出血手术预后的独立危险因素(P<0.05)。结论高血压性脑出血手术预后的影响因素较多,为了更好地改善病人预后,需要对多种因素进行综合分析处理。Objective To analyze the factors related to the prognoses in the patients with hypertensive cerebral hemorrhage（HCH）undergoing the surgery. Methods Of 84 patients with HCH who underwent surgery from January, 2014 to January, 2017, 37 had good prognoses（GOS scores ≥ 3 points） and 47 poor prognoses（GOS scores ≤ 2 points）. The factors related to their prognoses were analyzed by univariate and multivariate logistic regression analysis. Results The univariate analysis showed that the prognoses were related to patients＇ age, hypertension history, diabetes mellitus, preoperative GCS, hemorrhage volume and postoperative complication in the patients with HCH undergoing the surgery. The multivariate logistic regression analysis showed that the independent risk factor related to the prognoses included age ≥ 65 years, hypertension history ≥ 10 years, preoperative CGS scores ≤ 9 points, bleeding volume ≥ 30 ml and postoperative complications ≥ 2 in the patients with HCH undergoing the surgery（P〈0.05）. Conclusions Age ≥ 65 years, history of hypertension ≥ 10 years, preoperative GCS score ≤ 9 points, bleeding volume ≥ 30 ml and postoperative complications ≥ 2 are independent risk factors of prognoses in the patients with HCH undergoing the surgery.

关 键 词：高血压性脑出血 手术治疗 预后 影响因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]