[1]谢明德 金 法 冯荣亮.高血压性脑出血血肿清除术后癫痫发作的影响因素分析[J].中国临床神经外科杂志,2019,(10):605-607.[doi:10.13798/j.issn.1009-153X.2019.10.009]
 XIE Ming-de,JIN Fa,FENG Rong-liang..Factors related to epileptic seizures after evacuation of intracerebral hematomas in patients with hypertensive intracerebral hemorrhage[J].,2019,(10):605-607.[doi:10.13798/j.issn.1009-153X.2019.10.009]
点击复制

高血压性脑出血血肿清除术后癫痫发作的影响因素分析()
分享到:

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

卷:
期数:
2019年10期
页码:
605-607
栏目:
论著
出版日期:
2019-10-20

文章信息/Info

Title:
Factors related to epileptic seizures after evacuation of intracerebral hematomas in patients with hypertensive intracerebral hemorrhage
文章编号:
1009-153X(2019)10-0605-03
作者:
谢明德 金 法 冯荣亮
526600 广东,德庆县人民医院神经外科(谢明德);510000 广州,南方医科大学珠江医院神经外科(金 法);526000 广东,肇庆市第一人民医院神经外科(冯荣亮)
Author(s):
XIE Ming-de1 JIN Fa2 FENG Rong-liang3.
1. Department of Neurosurgery, Deqing County People's Hospital, Zhaoqing 526600, China; 2. Department of Neurosurgery, Pearl River Hospital, Southern Medical University, Guangzhou 510000, China; 3. Department of Neurosurgery, Zhaoqing Municipal First People's Hospital, Zhaoqing 526000, China
关键词:
高血压性脑出血开颅血肿清除术癫痫危险因素
Keywords:
Hypertensive intracerebral hemorrhage Craniotomy hematoma removal Epileptic Risk factors
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2019.10.009
文献标志码:
A
摘要:
目的 探讨高血压性脑出血颅内血肿清除术后并发癫痫发作的影响因素。方法 回顾性分析2011年3月至2018年7月开颅血肿清除术治疗的485例高血压性脑出血的临床资料。采用多因素logistic回归分析检验术后并发癫痫的危险因素。结果 485例中,术后发生癫痫62例(12.9%)。多因素logistic回归分析结果显示,血肿体积≥60 ml、血肿位于小脑、术后再出血、术后电解质紊乱、脑电图异常、术前C反应蛋白(CRP)水平升高、术前肿瘤坏死因子-α(TNF-α)水平升高、术前白细胞介素-6(IL-6)水平升高是术后并发癫痫发作的独立危险因素(P<0.05)。结论 高血压性脑出血开颅血肿清除术后癫痫发作发生率较高,对于血肿较大、血肿位于小脑、术后再出血、术后电解质紊乱、脑电图异常、术前CRP、TNF-α、IL-6水平升高的病人,应采取针对性措施预防术后癫痫发作。
Abstract:
Objective To investigate the factors related to the postoprative epileptic seizures in the patients with hypertensive intracerebral hemorrhage (HICH). Methods The clinical data of 485 patients with HICH treated by evacuation of intracerebral hematomas in our hospital from March, 2011 to July, 2018 were analyzed retrospectively. Of these 485 patients, 62 had epileptic seizures and 423 not. The factors related to the postoperative epileptic seizures were statistically analyzed. Results The univariate analysis showed that the factors related to the postoperative epileptic seizures included the patient's age, volume and location of intracerebral hematomas, postoperative rebleeding, electrolyte level, preoperative levels of serum C-reactive protein (CRP), tumor necrosis (TNF-a) and interleukin-6 (IL-6) and hydrocephalous (P<0.05). The multivariate logistic regression analysis showed that the independent risk factors related to the postoperative epileptic seizures included the large volume of hematoma, hematoma located in the cerebellum, postoperative rebleeding, electrolyte disturbance, higher levels of preoperative serum CRP, TNF-α and IL-6 (P<0.05). Conclusion It is suggested the incidence of postoperative epileptic seizures is very high after the surgery in the HICH patients undergoing craniotomy who have cerebellar hematomas, hematoma volume>45 ml, disturbance of electrolyte level, higher levels of preoperative serum CRP, TNF-a and IL-6 and postoperative cerebral rebleeding.

参考文献/References:

[1] Herweh C, Nordlohne S, Sykora M, et al. Climatic and sea- sonal circumstances of hypertensive intracerebral hemorr- hage in a worldwide cohort [J]. Stroke, 2017, 48(12): 3384- 3389. [2] 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,2018,23(10): 662-664. [3] 马 俊,周 勇,马元施,等. 经外侧裂-岛叶入路显微手 术治疗高血压性基底节区出血的疗效分析[J]. 中国临床 神经外科杂志,2018,23(9):613-615. [4] 伍伟俊,谢德斌,贺建雄,等. 经外侧裂岛叶入路显微手术 治疗高血压性基底节区出血[J]. 中国临床神经外科杂 志,2017,22(11):775-776. [5] 林 晖,吴光辉,刘美秋. 经中央沟下点入路显微手术治 疗优势半球高血压性基底节区出血[J]. 中国临床神经外 科杂志,2018,23(10):659-661. [6] Yang G, Shao GF. Elevated serum IL-11, TNF α, and VEGF expressions contribute to the pathophysiology of hyperten- sive intracerebral hemorrhage (HICH) [J]. Neurolog Sci, 2016, 37(8): 1-7. [7] 王新德. 各类脑血管疾病诊断要点[J]. 中华神经科杂志, 1996,3(6):379-380. [8] 刘稀金,陈勇军,张 平,等. 左乙拉西坦与卡马西平治疗 高血压脑出血后癫痫的疗效对比分析[J]. 北方药学, 2017,14(3):7-8. [9] 林 驰,宗希涛,刘倩绫,等. 亚高原高血压脑出血后继发 癫痫的发生率及治疗的临床统计分析[J]. 立体定向和功 能性神经外科杂志,2016,35(6):363-364. [10] 时敬国,常鹏飞,李 明,等. 神经内窥镜与开颅手术治疗 高血压脑出血的疗效比较[J]. 中华实验外科杂志,2017, 34(2):308-310. [11] Cao S, Zheng M, Hua Y, et al. Hematoma changes during clot resolution after experimental intracerebral hemorrhage [J]. Stroke, 2016, 47(6): 1626-1631. [12] Beynon C, Sakowitz OW, Unterberg AW. Multiple electrode aggregometry in antiplatelet-related intracerebral haemorr- hage [J]. J Clin Neurosci, 2013, 20(12): 1805-1806. [13] 孙军山. 不同抗癫痫药物对脑出血癫痫病人认知功能障 碍的影响[J]. 实用临床医药杂志,2012,16(23):121-122. [14] 刘丹丹,孙美珍,赵俊萍. 血清及脑脊液中白介素-1β、白 介素-6及肿瘤坏死因子-α水平与病毒性脑炎急性期伴 癫痫发作的关系[J]. 中华临床医师杂志(电子版),2017, 11(16):2120-2124.

相似文献/References:

[1]霍龙伟.钻孔引流术与开颅清除术治疗高血压脑出血114例[J].中国临床神经外科杂志,2015,(06):372.[doi:10.13798/j.issn.1009-153X.2015.06.020]
[2]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]
[3]任允平.高血压性基底节区出血破入脑室的治疗体会[J].中国临床神经外科杂志,2016,(10):634.[doi:10.13798/j.issn.1009-153X.2016.10.025]
[4]何明亮,易铭佳,何永通,等.DTI技术在穿刺引流术治疗高血压性基底节区出血疗效评估中的价值[J].中国临床神经外科杂志,2016,(11):682.[doi:10.13798/j.issn.1009-153X.2016.11.010]
 HE Ming-liang,CHEN Rong-hao,CHEN Yin-yan,et al.Clinic effects of minimally invasive techniques on conscious patients with hypertensive basal ganglia hemorrhage and evaluation of the effects[J].,2016,(10):682.[doi:10.13798/j.issn.1009-153X.2016.11.010]
[5]石 浩,樊启涛,袁俊峰,等.小骨窗侧裂入路显微手术治疗高血压性基底节区出血的临床体会[J].中国临床神经外科杂志,2016,(11):715.[doi:10.13798/j.issn.1009-153X.2016.11.024]
[6]白宗旭,师 蔚,姜海涛.高血压性脑出血的个体化手术治疗[J].中国临床神经外科杂志,2016,(11):717.[doi:10.13798/j.issn.1009-153X.2016.11.025]
[7]张 淇,李 辉,方开萱.个体化手术治疗对不同部位高血压性脑出血近期预后的影响[J].中国临床神经外科杂志,2016,(12):762.[doi:10.13798/j.issn.1009-153X.2016.12.010]
 ZHANG Qi,LI Hui,FANG Kai-xuan.Effects of individualized surgical plan on recent prognoses in patients with hypertensive intracerebral hemorrhage[J].,2016,(10):762.[doi:10.13798/j.issn.1009-153X.2016.12.010]
[8]吴 亮,宋子木,夏鹤春,等.垂体脓肿的临床特点及经鼻蝶显微手术治疗[J].中国临床神经外科杂志,2016,(12):771.[doi:10.13798/j.issn.1009-153X.2016.12.013]
[9]李红闪,朱海涛,史彦芳,等.经侧裂-岛叶入路小骨窗显微手术治疗高血压性基底节区出血[J].中国临床神经外科杂志,2016,(12):777.[doi:10.13798/j.issn.1009-153X.2016.12.016]
[10]梁观钦,蔡厚洪,吴 举.多靶点软通道穿刺术治疗高血压性脑内巨型血肿[J].中国临床神经外科杂志,2016,(12):787.[doi:10.13798/j.issn.1009-153X.2016.12.021]
[11]田 军 屈 浙 姜 博 宋春旺 左书浩.钻孔引流术联合开颅血肿清除术治疗急危重症高血压性脑出血[J].中国临床神经外科杂志,2017,(05):305.[doi:10.13798/j.issn.1009-153X.2017.05.007]
 TIAN Jun,QU Zhe,JIANG Bo,et al.Treatment of acute severe hypertensive cerebral hemorrhage by burr hole drainage combined with craniotomy evacuation of hematomas[J].,2017,(10):305.[doi:10.13798/j.issn.1009-153X.2017.05.007]
[12]钟 琪 何 林 刘 平 郑燎原.神经内镜手术治疗高血压性脑出血的疗效分析[J].中国临床神经外科杂志,2020,(02):91.[doi:10.13798/j.issn.1009-153X.2020.02.010]
 ZHONG Qi,HE Lin,LIU Ping,et al.Effect of neuroendoscopic surgery on hypertensive cerebral hemorrhage[J].,2020,(10):91.[doi:10.13798/j.issn.1009-153X.2020.02.010]

备注/Memo

备注/Memo:
(2019-01-24收稿,2019-02-20修回)
更新日期/Last Update: 2019-10-20