立体定向微创技术治疗脑出血再出血风险的预测指标分析

目的:分析立体定向微创技术治疗脑出血再出血风险的预测指标。方法:纳入发病72h内入院并行立体定向微创手术治疗的脑出血患者295例,根据有无术后再出血分为再出血组68例及非再出血组227例;以有无再出血为因变量,以入院头颅CT值、血肿形态不规则、高血压病史为自变量进行二元Logistic回归分析,评估入院时CT平扫血肿形态及高血压病史与术后再出血之间的关系。结果:再出血组血肿形态不规则47例(69.1%),而非再出血组血肿不规则者仅69例(30.39%)。再出血组出院时神经功能评分明显高于非再出血组,拔管时残余血肿量也高于非再出血组。二元Logistic回归分析显示入院CT血肿形态不规则、入院CT值和高血压病史是术后再出血的独立预测因子。结论:入院CT值、血肿边界不规则、高血压病史是微创技术治疗脑出血后再出血的预测因素。

Factors for Predicting Postoperative Rebleeding after Minimally Invasive Stereotactic Surgery for Intracerebral Hemorrhage

To analyze the factors for predicting postoperative rebleeding in patients with intracerebral hemorrhage (ICH) after minimally invasive stereotactic surgery. Methods: A total of 295 ICH patients who underwent minimally invasive stereotactic surgery within 72 hours of symptom onset were included in the present study. Patients were divided into the rebleeding group (n=68) and non-rebleeding group (n=227) according to the presence or absence of postoperative rebleeding. With rebleeding and non-rebleeding as dependent variables and initial cranial CT values upon hospitalization, irregular hematoma, and history of hypertension as independent variables, we used binary Logistic regression to assess the relationship between the presence of postoperative rebleeding and the shape of initial hematoma and hypertension history. Results: There were 47 patients (69.1%) with irregular hematoma in the rebleeding group while only 69 patients (30.39%) in the non-rebleeding group. The NIHSS score at discharge of the rebleeding group was significantly higher than that of the non-rebleeding group. Upon extubation, the rebleeding group displayed greater residual hematoma volume than the non-rebleeding group. Binary Logistic regression showed that irregular hematoma, initial CT values, and hypertension history were independent predictors of postoperative rebleeding. Conclusion: CT value at hospitalization, irregular hematoma, and history of hypertension are predictive factors for postoperative rebleeding in patients who underwent minimally invasive stereotactic surgery for the treatment of ICH.