脑室改良Graeb评分对高血压脑出血破入脑室术后不良结局的评价作用分析  

Effect of Modified Graeb Score on the Evaluation of Adverse Outcomes after Hypertensive Intracerebral Hemorrhage Ruptured into the Ven⁃tricle

作　　者：梁世行 刘成辉 付剑 林启明 LIANG Shixing;LIU Chenghui;FU Jian;LIN Qiming(Department of Neurosurgery,Nanhai District People's Hospital,Foshan,Guangdong Province,528200 China)

机构地区：[1]佛山市南海区人民医院神经外科,广东佛山528200

出　　处：《系统医学》2022年第11期86-89,共4页Systems Medicine

摘　　要：目的研究脑室改良Graeb评分(mGS)对高血压脑出血(hypertensive cerebral hemorrhage,HICH)破入脑室术后不良结局的评价作用。方法选取2018年2月-2021年2月佛山市南海区人民医院收治的86例行手术治疗的HICH破入脑室患者为研究对象。按照术后3个月的格拉斯哥预后分级(GOS)的差异,将其分为预后不良组(GOS分级为Ⅰ~Ⅲ级,42例)和预后良好组(GOS分级为Ⅳ~Ⅴ级,44例)。分析两组患者的临床病历资料,并以多因素Logistic回归分析明确HICH破入脑室术后不良结局和相关影响因素的关系。结果年龄、脑室外引流、脑疝、梗阻性脑积水、mGS评分、GCS评分为HICH破入脑室术后不良结局的影响因素(P<0.05)。多因素Logistic回归分析得:年龄、脑疝及mGS评分均是HICH破入脑室术后不良结局的独立危险因素(OR=1.297、2.636、2.308,P<0.05),而GCS评分是HICH破入脑室术后不良结局的保护因素(OR=0.855,P<0.05)。结论mGS评分对HICH破入脑室术后不良结局的评价作用较佳,mGS评分越高预示患者脑室出血量的增加以及扩张程度越明显,从而导致患者的不良结局发生风险增加。Objective To study the effect of modified Graeb score(mGS) on the adverse outcome after hypertensive intracerebral hemorrhage(HICH) ruptured into the ventricle.Methods A total of 86 patients with HICH ruptured into the ventricle who were treated by Nanhai District People’s Hospital from February 2018 to February 2021 were selected as the study objects. According to the difference of Glasgow Outcome Scale(GOS) 3 months after operation,they were divided into poor prognosis group(GOS grading Ⅰ-Ⅲ, 42 cases) and the good prognosis group(GOS gradesⅣ-Ⅴ, 44 cases). The clinical medical records of the two groups of patients were analyzed. Multivariate Logistic regression analysis was used to clarify the relationship between adverse outcomes and related influencing factors after HICH ruptured into the ventricle.Results Age, ventricle drainage, brain herniation, obstructive hydrocephalus, mGS score, and GCS score were the influencing factors of adverse outcomes after HICH ruptured into the ventricle(P<0.05). Multivariate Logistic regression analysis showed that age, brain herniation and mGS score were independent risk factors for adverse outcomes after HICH ruptured into the ventricle(OR=1.297, 2.636, 2.308, P<0.05), the GCS score was a protective factor for adverse outcomes after HICH rupture into the ventricles(OR=0.855, P<0.05).Conclusion The mGS score has a better effect on the evaluation of adverse outcomes after HICH rupture into the ventricle. The higher the mGS score, the more obvious the increase in the amount of ventricular hemorrhage and the degree of dilatation, which leads to an increased risk of adverse outcomes in patients.

关 键 词：高血压脑出血 破入脑室 脑室改良Graeb评分 不良结局 

分 类 号：R651.1[医药卫生—外科学]