高血压性脑出血患者术后并发脑梗死的影响因素分析  

Influencing Factors of Postoperative Cerebral Infarction in Patients with Hypertensive Cerebral Hemorrhage

作　　者：曹小英[1] 隋曌[1] 邱治春[1] 范英俊[1] Cao Xiaoying;Sui Zhao;Qiu Zhichun;Fan Yingjun(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》2023年第4期475-478,共4页Journal of Chengdu Medical College

基　　金：成都医学院第一附属医院专项科学研究基金项目(No:CYFY2020YB06)。

摘　　要：目的探讨高血压性脑出血患者术后并发脑梗死的影响因素。方法回顾性分析成都医学院第一附属医院2019年3月至2022年3月收治的210例行开颅血肿清除术的高血压性脑出血患者临床资料,观察患者术后并发脑梗死的情况,并收集患者性别、年龄、吸烟史、饮酒史、高脂血症史、糖尿病史、高血压病史、术前格拉斯哥(GCS)评分、术前血肿量、脑疝及脑水肿体积等临床资料。高血压脑出血患者术后并发脑梗死的影响因素采用单因素分析,并发脑梗死的独立危险因素采用多因素Logistic回归分析。结果高血压性脑出血患者行开颅血肿清除术后并发脑梗死的发生率为24.76%(52/210),单因素分析显示,术后脑梗死发生率在性别、年龄、吸烟史、饮酒史方面的差异无统计学意义(P>0.05),但在合并高脂血症、糖尿病和高血压、术前GCS评分、术前血肿量、脑疝及脑水肿体积方面的差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,合并高脂血症、糖尿病,高血压病史≥10年,术前GCS评分<8分,术前血肿量≥40 mL,脑疝及脑水肿体积≥70 cm^(3)为影响高血压脑出血患者行开颅血肿清除术后并发脑梗死的独立危险因素。结论高血压脑出血患者行开颅血肿清除术后脑梗死的发生率受多种因素影响,临床上应选择性干预危险因素,从而降低脑梗死的发生率。Objective To explore the influencing factors of postoperative cerebral infarction in patients with hypertension cerebral hemorrhage(HCH).Methods A retrospective analysis was performed on 210 HCH patients who underwent craniotomy hematoma removal surgery in the First Affiliated Hospital of Chengdu Medical College from March 2019 to March 2022.Postoperative cerebral infarction of patients was observed.And the clinical data of patients including gender,age,smoking history,drinking history,hyperlipidemia hisory,diabetes history,hypertension history,preoperative Glasgow coma scale(GCS),preoperative hematoma volume,cerebral hernia and cerebral edema volume were collected.Univariate analysis was performed to determine the influencing factors of postoperative cerebral infarction in HCH patients.And multivariate Logistic regression analysis was performed to determine the independent risk factors of postoperative cerebral infarction in HCH patients.Results The incidence of cerebral infarction after craniotomy hematoma removal surgery in HCH patients was 24.76%(52/210).Univariate analysis showed that,with regard to the incidence of postoperative cerebral infarction,there was no statistically significant difference in gender,age,smoking history,and drinking history(P>0.05),but there were statistically significant differences in the complications of hyperlipidemia,diabetes,hypertension,preoperative GCS score,preoperative hematoma volume,cerebral hernia and cerebral edema volume(P<0.05).Multivariate Logistic regression analysis showed that complications of hyperlipidemia,diabetes,hypertension history≥10 years,preoperative GCS score<8 points,preoperative hematoma volume≥40 mL,cerebral hernia and cerebral edema volume≥70 cm^(3)were independent risk factors for cerebral infarction after craniotomy hematoma removal surgery in HCH patients.Conclusion The incidence of cerebral infarction after craniotomy hematoma removal surgery in HCH patients is affected by many factors,which should be selectively intervened in clinical prac

关 键 词：高血压性脑出血 血肿清除术 并发症 脑梗死 影响因素 

分 类 号：R651.11[医药卫生—外科学]