原发性脑出血血肿扩大的危险因素分析

目的分析导致原发性脑出血血肿扩大的危险因素。方法将324例原发性脑出血患者按血肿是否扩大分为血肿扩大组31例和非血肿扩大组293例,回顾性分析其临床资料及CT动态检查资料。结果原发性脑出血血肿扩大的高峰期为起病后6～24h,血肿扩大组病死率为67.74%明显高于无血肿扩大组的7.85%,差异有统计学意义(P<0.05)。主要与平均动脉压、收缩压、出血部位、血肿形态及血糖水平、肝肾功能异常、长期酗酒病史有关(P<0.05或P<0.01)。结论对原发性脑出血伴有继续出血高危因素的患者,应密切监测神经体征变化,血压、血糖及头颅CT的动态检测,以尽早采取相关措施,防止病情进行性恶化,降低病死率。

The risk factor analysis of hematoma enlargement of primary intracerebral hemorrhage

Objective To analyze the rick factor of hematoma enlargement of primary intracerebral hemorrhage. Methods 324 cases patients with primary intracerebral hemorrhage were divided into hematoma enlargement group（31 cases） and non-hematoma enlargement group（293 cases）, retrospective analyed clinical data and CT dynamic check information. Re- suits Expanding the peak of primary intracerebral hemorrhage after the onset of 24h, the case fatality rate of hematoma en- largement group （67.74%） was significantly higher than that of non-hematoma enlargement group （7.85 % ）, there was signifi- cant difference（ P 〈 0.05 ）. And mean arterial pressure, systolic blood pressure, bleeding sites, hematoma morphology and blood glucose level,liver and renal function abnormalities, history of chronic alcoholism （ P 〈 O. 05 or P 〈 O. 01 ）. Conclusion To the primary intracerebral hemorrhage patient which have continuous bleeding risk factor, should closely monitored the changes of the neurological sign, blood glucose, and head CT dynamic testing, to take relevant measure to prevent the progressive deterioration of the disease as soon as possible, and reduce the mortality.