高血压脑出血合并二次脑创伤因素的探讨  

Research of secondary insults and the prognosis of patients with hypertensive intracerebral hemorrhage

作　　者：宋少军[1] 章翔[1] 费舟[1] 吴景文[1] 

机构地区：[1]第四军医大学西京医院全军神经外科研究所,陕西西安710033

出　　处：《第四军医大学学报》2002年第23期2195-2197,共3页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金资助项目 (39870 673)

摘　　要：目的　观察二次脑损伤 (SBI)因素对高血压脑出血(HICH)预后的影响 .方法　采用前瞻性方法 ,总结 112例手术治疗的HICH患者的SBI因素 ,包括平均动脉压 (MAP)、颅内压(ICP)、脑灌注压 (CPP)、体温 (BT)及动脉氧饱和度 (SaO2 ) ,分析其与预后的关系 .结果　 6 7例 (6 0 % )患者合并有SBI,按Glasgow预后评分 (GOS) ,良好 14例 (2 1% )、中残 19例 (2 8% )、重残 2 4例 (36 % )、植物生存 4例 (6 % )、死亡 6例 (9% ) ;无SBI者 4 5例 (40 % ) ,恢复良好 16例 (36 % )、中残 2 0例 (44 % )、重残5例 (12 % )、植物生存 2例 (4% )、死亡 2例 (4% ) .结论　多数HICH患者不同程度的存在SBI,合并有MAP ,ICP ,CPP ,BT和SaO2AIM To observe the effects of secondary insults in patients with hypertensive intracerebral hemorrhage (HICH).METHODS Prospective study of 112 cases with HICH treated by surgery was conducted to sum up the factors of secondary insults and to analyze their relation and the prognosis. The factors included blood pressure (MAP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), body temperature (BT), saturation of artery oxygen (SaO2) and postoperative complication. RESULTS 67 patients (60%) were complicated with secondary brain injury (SBI). Among them, according to the Glasgow outcome scale (GOS), 14 patients (21%) had good recovery, 19 patients (28%) had moderate disability, 24 patients (36%) had severe disability, 4 patients (6%) were in persistent vegetative state and 6 patients (9%) died. Among the other 45 cases (40%) without SBI,16 patients (36%) had good recovery, 20 patients (44%) had moderate disability, 5 patients (12%) had severe disability, 2 patients (4%) were in persistent vegetative state and 2 (4%) died. CONCLUSION Most patients with HICH, to some degree, have SBI and the patients complicated with secondary injury have a bad prognosis.

关 键 词：高血压脑出血 二次脑创伤 预后 手术方法 

分 类 号：R651.12[医药卫生—外科学]