高血压脑出血血肿清除术后并发脑梗死的影响因素研究  

Study on the Influencing Factors of Cerebral Infarction after Hematoma Evacuation of Hypertensive Cerebral Hemorrhage

作　　者：钟兵 刘保国[1] 朱飚[1] 黄斌 张龙[1] 龙潮新[1] 郑建桥 张能 ZHONG Bing;LIU Baoguo;ZHU Biao;HUANG Bin;ZHANG Long;LONGChaoxin;ZHENG Jianqiao;ZHANG Neng(Yuebei People’s Hospital,Guangdong Province,Shaoguan 512026,China;不详)

机构地区：[1]广东省粤北人民医院,广东韶关512026

出　　处：《中国医学创新》2022年第9期161-164,共4页Medical Innovation of China

基　　金：韶关市卫生健康科研项目(Y20193)。

摘　　要：目的:探讨高血压脑出血血肿清除术后并发脑梗死的影响因素,并制订相应干预方案。方法:回顾性分析2018年1月-2020年12月在粤北人民医院接受血肿清除术治疗的207例高血压脑出血患者的临床资料,根据是否并发脑梗死,将并发脑梗死的患者设为脑梗死组(n=37),将无脑梗死发生的患者设为非脑梗死组(n=170)。比较两组患者的临床资料,并进行单因素分析与logistic回归分析。结果:207例高血压脑出血血肿清除术患者中37例并发脑梗死,发生率为17.87%;单因素分析结果显示,脑梗死组高血压病史长于非脑梗死组(P<0.05),收缩压、舒张压、血肿量、脑水肿体积较非脑梗死组均明显更高(P<0.05),降颅压药物使用时间>24 h比例明显更高(P<0.05),格拉斯哥昏迷评分(GCS)明显更低(P<0.05);两组年龄、性别、血糖水平比较,差异均无统计学意义(P>0.05)。logistic多因素分析结果显示,高血压病史、血肿量、脑水肿体积、收缩压、舒张压、降颅压药物使用时间>24 h、GCS评分是高血压脑出血血肿清除术后并发脑梗死发生的独立危险因素(P<0.05)。结论:高血压脑出血血肿清除术后并发脑梗死与高血压病史、血肿情况、水肿情况、血压、降颅压药物使用时间、GCS评分等存在密切关系,临床应针对上述因素进行针对性干预。Objective:To investigate the influencing factors of cerebral infarction after hematoma evacuation of hypertensive cerebral hemorrhage,and to formulate corresponding intervention programs.Method:The clinical data of 207 patients with hypertensive cerebral hemorrhage who underwent hematoma evacuation in Yuebei People’s Hospital from January 2018 to December 2020 was retrospectively analyzed,according to whether they were complicated by cerebral infarction,patients with cerebral infarction were set as cerebral infarction group (n=37),and patients without cerebral infarction were set as non-cerebral infarction group (n=170).The clinical data of the two groups were compared,and univariate analysis and logistic regression analysis were carried out.Result:Among 207 patients with hypertensive intracerebral hemorrhage undergoing hematoma evacuation,37 cases were complicated with cerebral infarction,and the incidence rate was 17.87%;univariate analysis showed that the history of hypertension in the cerebral infarction group was longer than that in the non-cerebral infarction group (P<0.05),systolic blood pressure,diastolic blood pressure,hematoma volume,edema volume were significantly higher than those in the non-cerebral infarction group (P<0.05),the proportion of intracranial pressure lowering drug use time >24 h was significantly higher (P<0.05),Glasgow coma score (GCS) was significantly lower (P<0.05);there were no significant differences in age,sex and blood glucose between the two groups (P>0.05).logistic multivariate analysis results showed that the history of hypertension,hematoma volume,edema volume,systolic blood pressure,diastolic blood pressure,intracranial pressure lowering drug use time >24 h and GCS score were independent risk factors for cerebral infarction after hematoma evacuation of hypertensive cerebral hemorrhage (P<0.05).Conclusion:Postoperative cerebral infarction after hematoma removal from hypertensive cerebral hemorrhage is closely related to the history of hypertension,hematoma,edema,blood pres

关 键 词：高血压 脑出血 血肿清除术 脑梗死 影响因素 

分 类 号：R651.1[医药卫生—外科学]