[1]徐 兵,雍成明,杨代明.高血压性脑出血手术预后的影响因素分析[J].中国临床神经外科杂志,2018,(10):662-664.[doi:10.13798/j.issn.1009-153X.2018.10.007]
　XU Bing,RUAN Cheng-ming,YANG Dai-ming..Analysis of factors related to prognoses in patients with hypertensive intracerebral hemorrhage[J].,2018,(10):662-664.[doi:10.13798/j.issn.1009-153X.2018.10.007]
点击复制

高血压性脑出血手术预后的影响因素分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年10期
页码:
662-664
栏目:
论著
出版日期:
2018-10-25

文章信息/Info

Title:
Analysis of factors related to prognoses in patients with hypertensive intracerebral hemorrhage
文章编号:
1009-153X（2018）10-0662-03
作者:
徐 兵; 雍成明; 杨代明
238000 合肥，安徽医科大学附属巢湖医院神经外科（徐兵、雍成明、杨代明）
Author(s):
XU Bing;  RUAN Cheng-ming;  YANG Dai-ming.
Department of Neurosurgery, Chaohu Hospital Affiliated to Anhui Medical University, Hefei 238000, China
关键词:
高血压性脑出血; 手术治疗; 预后; 影响因素
Keywords:
Hypertensive cerebral hemorrhage;  Prognosis;  Risk factors;  Surgery;  Statistical analysis
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2018.10.007
文献标志码:
A
摘要:
目的 探讨手术治疗高血压性脑出血预后的影响因素。方法 回顾性分析2014年1月至2017年1月收治的84例手术治疗的高血压性脑出血的临床资料，术后3个月GOS评分3~5分为预后良好，1~2分预后不良。采用多因素Logistic回归检验预后影响因素。结果 84例中，预后良好37例，预后不良47例。多因素Logistic回归分析显示，年龄≥65岁、高血压病史≥10年、术前CGS评分低、出血量≥30 ml和术后并发症≥2种为高血压性脑出血手术预后的独立危险因素（P<0.05）。结论 高血压性脑出血手术预后的影响因素较多，为了更好地改善病人预后，需要对多种因素进行综合分析处理。
Abstract:
Objective To analyze the factors related to the prognoses in the patients with hypertensive cerebral hemorrhage (HCH) undergoing the surgery. Methods Of 84 patients with HCH who underwent surgery from January, 2014 to January, 2017, 37 had good prognoses (GOS scores ≥ 3 points) and 47 poor prognoses (GOS scores ≤ 2 points). The factors related to their prognoses were analyzed by univariate and multivariate logistic regression analysis. Results The univariate analysis showed that the prognoses were related to patients’ age, hypertension history, diabetes mellitus, preoperative GCS, hemorrhage volume and postoperative complication in the patients with HCH undergoing the surgery. The multivariate logistic regression analysis showed that the independent risk factor related to the prognoses included age ≥ 65 years, hypertension history ≥ 10 years, preoperative CGS scores ≤ 9 points, bleeding volume ≥ 30 ml and postoperative complications ≥ 2 in the patients with HCH undergoing the surgery (P<0.05). Conclusions Age ≥ 65 years, history of hypertension ≥ 10 years, preoperative GCS score ≤ 9 points, bleeding volume ≥ 30 ml and postoperative complications ≥ 2 are independent risk factors of prognoses in the patients with HCH undergoing the surgery.

参考文献/References:

[1] 张纯伟. 神经外科中微创手术的应用价值[J]. 中国社区医 师，2016，32（33）：26-27.
[2] Rusconi A, Sangiorgi S, Bifone L, et al. Infrequent hemo- rrhagic complications following surgical drainage of chronic subdural hematomas [J]. J Korean Neurosurg Soc, 2015, 57(5): 379-385.
[3] 王立江，张吉荣，韩光良，等. CT定位下微创穿刺治疗高 血压基底节区脑出血短期疗效分析[J]. 中华老年心脑血 管病杂志，2014，16（4）：391-394.
[4] 唐 黎，赵 冬，朱立仓，等. 高血压脑出血短期预后相关 因素研究[J]. 中国实用神经疾病杂志，2016，19：30-32.
[5] Krishna SB, Ma L, Lan ZG, et al. Surgical management of spontaneous hypertensive brainstem hemorrhage [J]. Interdisciplinary Neurosurg, 2015, 2(3): 145-148.
[6] 黄俊红. 早期基底节区高血压脑出血术后预后的多因素 分析[J]. 中国实用神经疾病杂志，2014，17（8）：24-26.
[7] Guo R, Ma L, Krishna SB, et al. A retrospective clinical study of 98 adult idiopathic primary intraventricular hemorrhage cases [J]. Medicine (Baltimore), 2016, 95(42): e5089.
[8] Satoru T, Yoshio T, Masaokab H, et al. Decompressive craniectomy for arteriovenous malformation-related intra- cerebral hemorrhage [J]. J Clin Neurosci, 2015, 22(3): 483- 487.
[9] 谢 嵘，李少平，丁天凌，等. 用凝血功能综合评分法分析 高血压脑出血急性期血肿扩大的相关因素[J]. 中国临床 神经科学，2014，22（3）：296-300.
[10] Roxanna MG, Seungwon Y, Matthew BP. Treatment for intracerebral aneurysms between 2008 and 2013 from a national database [J]. World Neurosurg, 2016, 96(1): 230- 236.
[11] 姚开立. 手术治疗高血压脑出血短期预后因素分析[J]. 岭 南现代临床外科，2013，13（3）：214-217.
[12] Schmidt LB, Goertz S, Wohlfahrt J, et al. Recurrent intra- cerebral hemorrhage: associations with comorbidities and medicine with antithrombotic effects [J]. PLoS One, 2016, 11(11): e0166223.
[13] 吴云龙. 高血压脑出血外科手术治疗的预后相关影响因 素调查[J]. 中国现代医生，2012，50（6）：23-25.
[14] Elnar T, Bunc G. Primary intracerebral haematoma evacua- tion: a case report [J]. Br J Med Med Res, 2016, 14(8): 122- 123.
[15] 杨梅庭，丁丽君，李春茂，等. 基底节区血肿术后血肿残留 量对近期预后的影响[J]. 中国现代医生，2012，50（31）： 34-35.
[16] 符黄德，邓元央，黄华东，等. 高血压脑出血病人术后近期 预后影响因素分析[J]. 中国实用神经疾病杂志，2015，18 （17）：16-17.
[17] Schmidt LB, Goertz S, Wohlfahrt J, et al. Recurrent intra- cerebral hemorrhage: associations with comorbidities and medicine with antithrombotic effects [J]. PLoS One, 2016, 11(11): 1-14.
[18] 王茂凯，刘京平，陈焕磊. 高血压脑出血外科治疗近期预 后多因素分析[J]. 中外医疗，2016，10（1）：7-8.
[19] Chi FL, Lang TC, SJ, et al. Relationship between different surgical methods, hemorrhage position, hemorrhage volume, surgical timing, and treatment outcome of hypertensive intracerebral hemorrhage [J]. World J Emerg Med, 2014, 5 (3): 203-208.
[20] 韦树德，韦廷求，蒙智恩，等. 幕上高血压脑出血微创手术 治疗近期预后影响因素[J]. 广西医学，2012，37：417-418.

相似文献/References:

[1]庞陆军　张恒柱　李育平　严正村　王杏东　魏　民.慢性硬膜下血肿术前影像学分型和手术治疗[J].中国临床神经外科杂志,2016,(02):101.[doi:10.13798/j.issn.1009-153X.2016.02.014]
[2]李　强　许琼冠　刘达远　徐鹏翔.外伤性上矢状窦破裂的手术治疗[J].中国临床神经外科杂志,2015,(12):753.[doi:10.13798/j.issn.1009-153X.2015.12.017]
[3]叶　桓　卢　迪　魏荣胜　吕　亮　何　娟.婴幼儿先天性皮毛窦的诊断和手术治疗[J].中国临床神经外科杂志,2015,(12):755.[doi:10.13798/j.issn.1009-153X.2015.12.018]
[4]张　锟　尹晓亮　刘　磊　董雪涛　张新庆.神经内镜手术治疗高血压脑出血临床观察[J].中国临床神经外科杂志,2015,(08):483.[doi:10.13798/j.issn.1009-153X.2015.08.013]
[5]韩芸峰　王振宇　陈晓东.椎管内侵袭型血管脂肪瘤的诊断和手术治疗[J].中国临床神经外科杂志,2015,(03):134.[doi:10.13798/j.issn.1009-153X.2015.03.002]
　HAN Yun-feng,WANG Zhen-yu,CHEN Xiao-dong..Diagnosis and surgical treatment of infiltrating spinal angiolipoma[J].,2015,(10):134.[doi:10.13798/j.issn.1009-153X.2015.03.002]
[6]马　炜　张　华　李焕发　王　超　孟　强　刘　备　武　昊.伴有丛集发作的儿童癫痫患者的手术治疗[J].中国临床神经外科杂志,2015,(01):8.[doi:10.13798/j.issn.1009-153X.2015.01.003]
　MA Wei,ZHANG Hua,LI Huan-fa,et al.Surgery for children with epilepsy and seizure clustering (report of 33 cases)[J].,2015,(10):8.[doi:10.13798/j.issn.1009-153X.2015.01.003]
[7]蒋金泉　郭建杰　何金定　沈礼琴　赵海林.超早期立体定向手术治疗高血压小脑出血[J].中国临床神经外科杂志,2015,(02):101.[doi:10.13798/j.issn.1009-153X.2015.02.012]
[8]孟　玮 综述　周洪语 审校.难治性癫痫持续状态的治疗进展[J].中国临床神经外科杂志,2015,(02):119.[doi:10.13798/j.issn.1009-153X.2015.02.021]
[9]孙其凯　李珍珠　曹智洁　高　强　王清波　陈　正　耿　鑫　李泽福.3D打印模型引导下经颞部穿刺引流术治疗颅内血肿[J].中国临床神经外科杂志,2016,(10):586.[doi:10.13798/j.issn.1009-153X.2016.10.004]
　SUN Qi-kai,LI Zhen-zhu,CAO Zhi-jie,et al.Treatment of hypertensive cerebral hemorrhage by the minimally invasive puncture via temporal region under the guidance of 3D printing model[J].,2016,(10):586.[doi:10.13798/j.issn.1009-153X.2016.10.004]
[10]张开鹏　刘德财　金　澎.颅内血管母细胞瘤的诊断及显微手术治疗[J].中国临床神经外科杂志,2016,(10):601.[doi:10.13798/j.issn.1009-153X.2016.10.010]
　ZHANG Kai-peng,LIU De-cai,JIN Peng..Diagnosis and microsurgical treatment of intracranial hemangioblastomas[J].,2016,(10):601.[doi:10.13798/j.issn.1009-153X.2016.10.010]
[11]文戴华　易　丹.幕上高血压性脑出血个体化手术治疗[J].中国临床神经外科杂志,2017,(10):709.[doi:10.13792017.09/j.issn.1009-153X.2017.10.013]
[12]蒋福刚　李　军.持续有创颅内压监测在高血压性脑出血手术中的应用[J].中国临床神经外科杂志,2018,(07):488.[doi:10.13798/j.issn.1009-153X.2018.07.013]

更新日期/Last Update: 2018-09-30