三级高血压自发性脑出血患者早期血肿扩大的影响因素分析  

Analysis of influencing factors of early hematoma enlargement in patients with tertiary hypertensive spontaneous intracerebral hemorrhage

作　　者：杜欣蔓 陈刚 DU Xinman;CHEN Gang(Department of Cardiology,the First People's Hospital of Wuhu City,Wuhu,Anhui 241000,China;Department of Neurosurgery,the Second Affiliated Hospital of Wannan Medical College,Wuhu,Anhui 241001,China)

机构地区：[1]芜湖市第一人民医院心血管内科,安徽芜湖241000 [2]皖南医学院第二附属医院神经外科,安徽芜湖241001

出　　处：《医药前沿》2025年第8期47-50,共4页Journal of Frontiers of Medicine

摘　　要：目的分析三级高血压自发性脑出血患者早期血肿扩大的影响因素。方法选取2021年9月—2024年8月芜湖市第一人民医院和皖南医学院第二附属医院收治的三级高血压自发性脑出血患者72例,收治6 h内全部患者均完成基线CT扫描,并在首次扫描后24h内进行CT扫描复查,根据血肿扩大情况分为血肿扩大组和非血肿扩大组,对患者临床、影像学资料等进行回顾性分析,通过多因素Logistic回归模型对三级高血压自发性脑出血患者早期血肿扩大的影响因素进行分析。结果72例三级高血压自发性脑出血患者中,CT扫描复查发现26例患者发生早期血肿扩大,早期血肿扩大发生率为36.11%。单因素分析发现,血肿扩大组的吸烟史、混合征象、岛征象、漩涡征象与非血肿扩大组比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析发现,吸烟史、混合征象是三级高血压自发性脑出血患者早期血肿扩大的影响因素(P<0.05)。结论临床资料中的吸烟史联合影像学资料中的混合征象对三级高血压自发性脑出血患者早期血肿扩大存在一定的临床预测价值。Objective To analyze the influencing factors of early hematoma enlargement in patients with tertiary hypertensive spontaneous intracerebral hemorrhage.Methods A total of 72 patients with tertiary hypertensive spontaneous intracerebral hemorrhage admitted to the First People's Hospital of Wuhu City and the Second Affiliated Hospital of Wannan Medical College from September 2021 to August 2024 were selected,all patients completed baseline CT scan within 6 hours of admission,in addition,CT scan was performed within 24 hours after the first scan,and the patients were divided into the expanded hematoma group and the non-expanded hematoma group according to the enlargement of hematoma,the clinical and imaging data of the patients were retrospectively analyzed,and the influencing factors of early hematoma enlargement in patients with tertiary hypertensive spontaneous intracerebral hemorrhage were analyzed by multivariate logistic regression model.Results Among 72 patients with tertiary hypertensive spontaneous intracerebral hemorrhage,CT scan results showed that 26 patients had hematoma enlargement,and the incidence of early hematoma enlargement was 36.11%.The results of univariate analysis showed that the smoking history,mixed signs,island signs,and whirlpool signs in the enlarged hematoma group were significantly different from those in the non-enlarged hematoma group(P<0.05).The results of multifactor analysis showed that smoking history and mixed signs were the influencing factors of early hematoma enlargement in patients with tertiary hypertensive spontaneous intracerebral hemorrhage were analyzed by multivariate logistic regression model(P<0.05).Conclusions The clinical data smoking history combined with the imaging data mixed signs have certain clinical predictive value for early hematoma enlargement in patients with tertiary hypertensive intracerebral hemorrhage.

关 键 词：高血压 脑出血 临床资料 影像征象 血肿扩大 影响因素 

分 类 号：R743[医药卫生—神经病学与精神病学]