[1]沈　华.高血压脑出血术后再出血危险因素分析[J].中国临床神经外科杂志,2016,(06):366-367.[doi:10.13798/j.issn.1009-153X.2016.06.015]
　SHEN Hua.Analysis of risk factors related to rebleeding after surgery and its prevention in patients with hypertensive cerebral hemorrhage[J].,2016,(06):366-367.[doi:10.13798/j.issn.1009-153X.2016.06.015]
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高血压脑出血术后再出血危险因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年06期
页码:
366-367
栏目:
论著
出版日期:
2016-06-25

文章信息/Info

Title:
Analysis of risk factors related to rebleeding after surgery and its prevention in patients with hypertensive cerebral hemorrhage
文章编号:
1009-153X（2016）06-0366-02
作者:
沈　华
224100 江苏，盐城市大丰人民医院神经外科（沈　华）
Author(s):
SHEN Hua
Department of Neurosurgery, Dafeng Renmin Hospital, Yancheng 224100, China
关键词:
高血压脑出血; 显微手术; 术后再出血; 危险因素
Keywords:
Hypertensive cerebral hemorrhage;  Postoperative;  Surgery rebleeding risk factors;  Prevention
分类号:
R 743.34; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2016.06.015
文献标志码:
A
摘要:
目的 探讨高血压脑出血（HICH）术后再出血的危险因素。方法 回顾性分析2012年1月至2015年9月手术治疗的50例HICH的临床资料，根据术后CT检查判断再出血。结果 术后发生再出血14例，发生率为28.0%。单因素分析显示，再出血患者中，高血压病史>5年比例、术后躁动比例和术后血压波动比例均明显高于术后未出血患者（P <0.05），而术中发现责任动脉比例却明显低于术后未出血患者（P <0.05）。多因素Logestic回归分析显示术后血压波动（OR=14.692；95% CI为1.220~176.890；P=0.034）是术后发生再出血的独立危险因素，而术中发现责任动脉（OR=0.056；95% CI为0.005~0.652；P=0.021）却可以显著减少术后再出血发生率。结论 术中加强责任动脉的电凝止血、术后控制血压平稳有助于避免和减少HICH术后再出血。
Abstract:
Objective To study the risk factors related to rebleeding after surgery and measures of its prevention in the patients with hypertensive cerebral hemorrhage (HCH). Methods The clinical data of 50 patients with HCH, of whom, 14 had cerebral rebleeding and 36 not after the surgery, were analyzed retrospectively. The monofactorial and multifactorial analyses of the risk factors relate to the postoperative rebleeding were performed in these patients. Results The monofactorial analysis showed that the factors related to postoperative rebleeding included the long course of hypertension (>5 years), postoperative restless movement, postoperative fluctuation of blood pressure and intraoperatively undiscovered arteries responsible for the cerebral hemorrhage. The multifactorial analysis showed that the postoperative fluctuation of blood pressure and postoperatively undiscovered arteries responsible for the cerebral hemorrhage were the risk factors related to postoperative rebleeding. Conclusions It is suggested that the key to the prevention of cerebral rebleeding after the operation lies in the finding the arteries responsible for the cerebral hemorrhage and completely stopping bleeding in the operation as well keeping the blood pressure stabilizing after the operation in the patients with HCH.

参考文献/References:

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更新日期/Last Update: 2016-06-20