老年脑出血患者早期血肿扩大的多因素分析及其对预后的影响  

Multi-factor analysis of early expansion of hematoma in elderly patients with cerebral hemorrhage and its impact on prognosis

作　　者：李超峰 刘智 薛俊刚 许赞峰 陈刚 别小华 Li Chaofeng;Liu Zhi;Xue Jungang(Department of Neurosurgery,Xi'an Red Cross Hospital,Xi'an 710054,China;Shaanxi Trific Hospital,Xi'an 710068,China)

机构地区：[1]西安市红会医院神经外科,710054 [2]陕西省交通医院,710068

出　　处：《美中国际创伤杂志》2024年第3期13-15,36,39,60,共6页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨老年脑出血患者早期血肿扩大的相关因素及其对预后的影响。方法:纳入2016年1月至2020年3月我们收治的104例老年脑出血患者,依据是否存在早期血肿扩大发生率将其分为两组。比较两组患者的临床资料,采用二元logistic回归分析血肿扩大的危险因素,并在3个月随访中比较两组的预后情况。结果:扩大组患者的收缩压、血肿不均质率和血糖水平显著高于对照组,而GCS评分显著低于对照组(P<0.05)。收缩压、血肿不均质、GCS评分和血糖是早期血肿扩大的独立危险因素(P<0.05)。扩展组的不良预后发生率高于对照组(P<0.05)。结论:早期血肿扩大与GCS评分、血肿不均质、血压及血糖水平密切相关,并显著影响患者预后。临床上应密切关注GCS评分低、血肿不均质、高血压和高血糖患者,及时干预以减少不良预后风险。Objective:To explore the relevant factors of early expansion of hematoma in elderly patients with cerebral hemorrhage and their impact on prognosis.Methods:104 elderly patients with cerebral hemorrhage admitted by us from January 2016 to March 2020 were divided into two groups according to the incidence of early hematoma expansion.Compare the clinical data of the two groups of patients,use binary logistic regression to analyze the risk factors for hematoma expansion,and compare the prognosis of the two groups in a 3-month follow-up.Results:The systolic blood pressure,hematoma hemogeneity rate and blood glucose levels of patients in the expanded group were significantly higher than those in the control group,while the GCS score was significantly lower than that in the control group(P<0.05).Systolic blood pressure,hematoma homogeneity,GCS score and blood glucose are independent risk factors for early hematoma expansion(P<0.05).The incidence of bad prognosis in the extended group is higher than that in the control group(P<0.05).Conclusion:Early expansion of hematoma is closely related to GCS score,hematoma hemogeneity,blood pressure and blood glucose levels,and significantly affects the prognosis of patients.In clinical practice,close attention should be paid to patients with low GCS scores,heterogeneous hematoma,hypertension,and hyperglycemia,and timely intervention should be taken to reduce the risk of poor prognosis.

关 键 词：老年 脑出血 早期血肿扩大 影响因素 预后 

分 类 号：R65[医药卫生—外科学]