高血压脑出血术后发生中重度脑水肿的危险因素  

Risk Factors of Moderate to Severe Cerebral Edema After Hypertensive Intracerebral Hemorrhage Surgery

作　　者：冯亚菲 王菲 FENG Yafei;WANG Fei(Neurosurgery,Wuyang County People’s Hospital,Luohe 462400,China;Neurosurgery,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473007,China)

机构地区：[1]舞阳县人民医院神经外科,河南漯河462400 [2]南阳医学高等专科学校第一附属医院神经外科,河南南阳473007

出　　处：《河南医学研究》2022年第12期2209-2212,共4页Henan Medical Research

摘　　要：目的分析高血压脑出血(HICH)患者术后发生中重度脑水肿的危险因素。方法选取2019年8月至2021年4月舞阳县人民医院收治的322例HICH术后脑水肿患者。根据术后CT复查情况分为中重度脑水肿组(148例)和轻度脑水肿组(174例)。分析HICH术后中重度脑水肿形成的影响因素。结果两组发病至手术时间、入院格拉斯哥昏迷指数(GCS)评分、高血压病程、入院时收缩压(SBP)、手术方式、术前血肿量、术前瞳孔改变、中线移位、血小板CD42b、血小板CD62p对比,差异有统计学意义(P<0.05)。发病至手术时间>24 h、入院GCS评分≤9分、高血压病程>5 a、常规手术、术前血肿量>35 mL、术前瞳孔改变、中线移位、血小板CD42b<70%、血小板CD62p>15%是HICH术后中重度脑水肿形成的危险因素(P<0.05)。结论发病至手术时间与高血压病程过长、术前昏迷程度、血肿量、瞳孔改变及血小板CD42b、CD62p等均为HICH术后中重度脑水肿形成的重要危险因素。Objective To analyze the related risk factors of moderate to severe cerebral edema after hypertensive intracerebral hemorrhage(HICH)surgery.Methods A total of 322 patients with cerebral edema after HICH who were admitted to Wuyang County People’s Hospital from August 2019 to April 2021 were selected.They were divided into moderate-severe cerebral edema group(148 cases)and mild cerebral edema group(174 cases)according to postoperative CT review.The influencing factors of moderate and severe cerebral edema after HICH were analyzed.Results There were differences between the two groups in time from onset to operation,Glasgow coma scale(GCS)score at admission,course of hypertension,systolic blood pressure(SBP)at admission,operation mode,preoperative hematoma volume,preoperative pupil change,midline shift,platelet CD42b and platelet CD62p(P<0.05).The time from onset to operation>24 hours,GCS score≤9 points at admission,hypertension course>5 years,routine operation,preoperative hematoma volume>35 mL,preoperative pupil change,midline shift,platelet CD42b<70% and platelet CD62p>15% were the risk factors for moderate and severe cerebral edema after the surgery of HICH(P<0.05).Conclusion The time from onset to operation,prolonged course of hypertension,preoperative coma,hematoma volume,pupillary changes,and platelet CD42b and CD62p are important risk factors for the formation of moderate to severe cerebral edema after HICH.

关 键 词：高血压脑出血 脑水肿 血肿量 血小板CD42b 血小板CD62P 

分 类 号：R651.12[医药卫生—外科学]