高血压脑出血患者急性期血肿增大的影响因素研究  

Influencing Factors of Hematoma Expansion in Patients with Hypertensive Intracerebral Hemorrhage in the Acute Phase

作　　者：曹小英[1] 隋曌[1] 杨中鑫[1] 邱治春[1] 刘海波[1] Cao Xiaoying;Sui Zhao;Yang Zhongxin;Qiu Zhichun;Liu Haibo(Department of Neurosurgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China)

机构地区：[1]成都医学院第一附属医院神经外科,成都610500

出　　处：《成都医学院学报》2021年第5期620-624,共5页Journal of Chengdu Medical College

摘　　要：目的探讨高血压脑出血患者急性期血肿增大的相关影响因素。方法回顾性纳入成都医学院第一附属医院2016年6月至2019年5月收治的高血压脑出血患者185例,根据急性期血肿是否增大,分为血肿增大组和血肿未增大组,收集患者各项病史资料及临床资料,单因素分析高血压脑出血患者急性期血肿增大的各项影响因素,多因素Logistic回归分析此类患者急性期血肿增大的独立危险因素。结果高血压脑出血患者急性期血肿增大的发生率为25.95%(48/185),两组患者在服用华法林、入院时格拉斯哥昏迷评分(GCS)、入院时美国国立卫生研究院卒中量表评分(NIHSS)、首次CT血肿体积、血肿破入脑室比例、血肿为分叶状或不规则状、凝血酶时间方面差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,发病前服用华法林、入院时GCS评分≤8分、入院时NIHSS评分>15分、首次CT血肿体积≥20 mL、血肿破入脑室、血肿为分叶状或不规则状是高血压脑出血患者急性期血肿增大的独立危险因素。结论高血压脑出血患者急性期血肿增大受发病前服用华法林、入院时GCS评分、入院时NIHSS评分、首次CT血肿体积、血肿破入脑室、血肿形态等因素影响,临床可根据上述因素预测血肿增大的可能性。Objective To investigate the related factors of hematoma expansion in patients with hypertensive intracerebral hemorrhage in the acute phase.Methods A total of 185 patients with hypertensive intracerebral hemorrhage admitted to the First Affiliated Hospital of Chengdu Medical College from June 2016 to May 2019 were retrospectively enrolled.According to whether the hematoma expanded in the acute phase,the patients were divided into hematoma expansion group and hematoma non-expansion group.Medical history and clinical data of the patients were collected.The influencing factors of hematoma expansion in patients with hypertensive intracerebral hemorrhage in the acute phase were analyzed by single factor analysis,and the independent risk factors were analyzed by multivariate logistic regression.Results The incidence of hematoma expansion in patients with hypertensive intracerebral hemorrhage in the acute phase was 25.95%(48/185).There were statistically significant differences between the two groups in warfarin administration,Glasgow coma scale(GCS)score on admission,national institutes of health stroke scale(NIHSS)score on admission,volume of hematoma at first CT,proportion of the hematoma breaking into the ventricle,lobulated or irregular hematoma,and thrombin time(P<0.05).Multivariate Logistic regression analysis showed that warfarin administration before onset,GCS score≤8 points on admission,NIHSS score>15 points on admission,volume of hematoma at first CT≥20 mL,hematoma breaking into the ventricle,and lobulated or irregular hematoma were independent risk factors for hematoma expansion in patients with hypertensive intracerebral hemorrhage in the acute phase.Conclusion Hematoma expansion in patients with hypertensive intracerebral hemorrhage in the acute phase is affected by factors such as warfarin administration before onset,GCS score at admission,NIHSS score at admission,volume of hematoma at first CT,hematoma breaking into the ventricle,and hematoma morphology,which can be clinically used as predictors of

关 键 词：高血压脑出血 血肿 疾病恶化 危险性评估 影响因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]