高血压脑出血术后再出血的影响因素及防治措施

目的观察高血压脑出血手术治疗后再出血的原因及影响因素,为临床防治提供理论依据。方法回顾性分析2011-08—2013-08在我科手术治疗的高血压脑出血155例患者临床资料。术后26例患者再次出血,采用单因素及Logistic多因素回归分析筛查术后再出血的影响因素。结果术后26例患者再次出血,发生率为16.7%。单因素分析提示发病至手术时间、术后收缩压、术后舒张压、手术方式、凝血功能、术后躁动与术后再出血有关（P〈0.05）。术后舒张压超过120mmHg、术后收缩压超过200mmHg、发病至手术时间低于6h、术前凝血功能异常、躁动是术后再出血的危险因素,而微创引流并不是术后再出血的独立危险因素。结论高血压脑出血术后再出血与手术时机、术后血压控制、凝血功能等有关,与微创或开颅手术方式无关,注意危险因素,从而降低再出血发生率,改善预后。

Risk factors and prevention measures of rehaemorrhagia of patients with hypertensive intracerebral hematioma

Objective To investigate the risk factors and prevention measures of rehaemorrhagia of patients with hypertensive intracerebral hematioma（HCH）.Methods The data of 155 patients with HCH received operative treatment from August2011 to August 2013 in our hospital were retrospectively analyzed.The risk factors of 26 patients with rehaemorrhagia were evaluated with the univariant analysis and multi factor logistical regression analysis.Results he analysis results showed that there were some factors related with postoperative rehaemorrhagia such as the period between initial bleeding to operation,post-operative SBP and DBP,operation methods,coagulation factor disorders and dysphoria,and SBP≥200mmHg,DBP≥120mmHg,time between initial bleeding to operation≤6h,coagulation factor disorders,dysphori were risk factors of postoperative rehaemorrhagia,Conclusion The postoperative rehaemorrhagia of patients with HCH is related with operative timing,postoperative blood pressure and coagulation function,and the rehaemorrhagia rate can be decreased by controlling corresponding risk factors.