高血压性脑出血患者小骨窗手术术后再出血的影响因素分析  

Influencing factors of rebleeding after small bone window surgery in patients with hypertensive intracerebral hemorrhage

作　　者：陈薇薇[1] 李春茂[1] 张礼均 CHEN Weiwei;LI Chunmao;ZHANG Lijun(Department of Neurosurgery,First People’s Hospital of Taizhou,Zhejiang,Taizhou 318020,China)

机构地区：[1]台州市第一人民医院神经外科,浙江台州318020

出　　处：《中国现代医生》2022年第25期14-17,共4页China Modern Doctor

基　　金：浙江省基础公益研究计划项目(GF20H090004)。

摘　　要：目的探讨高血压性脑出血(hypertensive intracerebral hemorrhage,HICH)患者小骨窗手术术后再出血的影响因素。方法选取2019年1月至2021年12月于台州市第一人民医院进行小骨窗手术的HICH患者150例为研究对象,通过自制调查问卷收集患者相关临床资料,统计HICH患者小骨窗手术术后再出血的发生率,采用多因素Logistic回归分析探究HICH患者小骨窗手术术后再出血的危险因素。结果在收回问卷的145例HICH患者中,35例发生术后再出血,再出血率24.14%。单因素分析结果显示,发病至手术时间<6h、术前收缩压≥200mmHg(1mmHg=0.133kPa)、术前舒张压≥120mmHg、高血压病程≥10年、凝血功能异常、血肿形状不规则、合并糖尿病、出血破入脑室的HICH患者小骨窗手术术后再出血的发生率较高,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,发病至手术时间<6h、术前收缩压≥200mmHg、术前舒张压≥120mmHg、高血压病程≥10年、凝血功能异常、血肿形状不规则、合并糖尿病、出血破入脑室均为影响HICH患者小骨窗手术术后发生再出血的主要危险因素(P<0.05)。结论手术时机、术前血压、高血压病程、凝血功能、血肿形状、合并糖尿病、出血破入脑室均是HICH患者小骨窗手术术后再出血的危险因素,应把握手术时机,严密监测患者的血压、凝血功能等,对改善患者预后意义深远。Objective To investigate the influencing factors of rebleeding after small bone window surgery in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 150 patients with HICH who underwent small bone window surgery in First People’s Hospital of Taizhou from January 2019 to December 2021 were selected as the research subjects.The relevant clinical data of the patients were collected through a self-made questionnaire,and the postoperative rebleeding of HICH patients after small bone window surgery was counted.Multivariate Logistic regression analysis was used to explore the risk factors of postoperative rebleeding in patients with HICH after small bone window surgery.Results Of the 145 HICH patients who returned the questionnaire,35 had postoperative rebleeding,and the rebleeding rate was 24.14%.Univariate analysis showed that the incidence of rebleeding after small bone window surgery in HICH patients the time from onset to operation was less than 6 hours,preoperative systolic blood pressure≥200mmHg(1mmHg=0.133kPa),preoperative diastolic blood pressure≥120mmHg,hypertension duration≥10 years,abnormal coagulation function,irregular shape of hematoma,complicated with diabetes mellitus,and bleeding into the ventricle were higher,and the differences were statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that the time from onset to operation<6h,preoperative systolic blood pressure≥200mmHg,preoperative diastolic blood pressure≥120mmHg,duration of hypertension≥10 years,abnormal coagulation function,irregular shape of hematoma,combined diabetes mellitus,bleeding into the ventricle were the main risk factor for rebleeding after small bone window surgery in HICH patients(P<0.05).Conclusion Operation timing,preoperative blood pressure,duration of hypertension,coagulation function,hematoma shape,diabetes mellitus,and ventricular rupture are risk factors for rebleeding after small bone window surgery in patients with HICH.Therefore,timing of su

关 键 词：高血压性脑出血 小骨窗手术 再出血 影响因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]