高血压脑出血外科手术治疗的预后相关影响因素调查

目的探讨影响高血压脑出血外科手术的预后相关影响因素，旨在提高高血压脑出血患者的生存率及生存质量。方法选择我院及浙江省人民医院神经外科2008年1月～2011年1月进行手术治疗的88例高血压脑出血患者作为研究对象．根据ADL评估预后显示，预后良好组共51例，预后差组共37例，对影响高血压脑出血外科手术治疗预后的单因素进行分析并进行Logistic多因素回归分析。结果患者的年龄、术前合并器质性疾病（高血压、糖尿病等）、出血量、手术时机、手术方法及术后并发症与高血压脑出血的预后关系密切（P〈0．05），均为影响高血压脑出血预后的重要因素。而性别、出血部位等与高血压脑出血的预后关系不显著（P〉0．05）。结论手术适应证、手术时机及手术方法的选择是影响患者预后的重要因素．要根据患者的发病情况进行综合分析，选择适宜的手术方式才能明显改善患者的预后和提高患者的生存质量。

Survey on the prognostic factors of surgery for hypertensive intracerebral hemorrhage

Objective To investigate the prognostic factors of surgery for hypertensive intracerebral hemorrhage and to improve survival and quality of life in patients with hypertensive intracerebral hemorrhage.Methods A total of 88 patients with hypertensive cerebral hemorrhage undergoing surgical treatment were selected as research objects in our hospital and department of neurosurgery in the people’s hospital of Zhejiang province from January 2008 to January 2011.According to ADL assessment,there were good prognosis group of 51 patients and poor prognosis group of 37 patients,and used single-factor analysis and Logistic regression analysis for the influence of surgical treatment on hypertensive intracerebral hemorrhage prognosis.Results The patient’s age,preoperative combined organic diseases(hypertension,diabetes,etc.),blood loss,surgical time,surgical techniques and postoperative complications and the prognosis of hypertensive intracerebral hemorrhage(P < 0.05) were important factors for influencing the prognosis of hypertensive intracerebral hemorrhage.And gender,the bleeding site were not significantly correlated with the prognosis of hypertensive intracerebral hemorrhage(P > 0.05).Conclusion Choice of surgical indications,timing of surgery and surgical methods is an important prognostic factor in patients with the disease,according to a comprehensive analysis of the situation,chooses the appropriate surgical approach in order to significantly improving outcomes and quality of life for patients.