高血压性脑出血术后再出血的多因素分析及预防

目的分析高血压性脑出血术后再出血的危险因素,探讨预防术后再出血的对策。方法回顾性分析356例高血压性脑出血手术病例,采用Logistic回归模型分析各种可能因素对术后再出血的作用。结果高血压脑出血早期术后再出血发生率为16.3%。单因素Logistic分析显示:术后血压的波动、出血(发病)至手术时间、术中止血困难或止血不彻底、出血部位和是否有影响凝血机制的因素与再出血的发生显著相关(P<0.05);多元逐步Logistic分析显示:术后血压的波动、出血(发病)至手术时间、术中止血困难或止血不彻底是再出血的危险因素(P<0.05)。结论术中止血彻底和术后控制血压平稳对预防再出血有重要意义。

Multiple Factor Analysis and Prevention on Recurrent Hemorrhage After Operation of Hypertensive lntracerebral Hemorrhage

Objective To analyze the influence of related factors on recurrent hemorrhage after operation of(hypertensive) intracerebral hemorrhage,and investigate the countermeasure against recurrent hemorrhage.Methods Three hundred and fifty-six patients with surgical treated hypertensive intracerebral hemorrhage were analyzed retrospectively.Logistic regression analysis was applied to analyze the function of various possible factors that might induce recurrent hemorrhage.Result The incidence of recurrent postoperative hemorrhage was 16.3 %. Univariant logistic analysis disclosed that postoperative blood pressure fluctuation,the period between initial bleeding to operation,difficulties met during the operation and inadequate hemostasis,the hemorrhage site and coagulation factor disorders significantly related with recurrence of hemorrhage(P<0.05).Multiple linear logistic regression analysis showed that fluctuation of blood pressure,time between initial bleeding to operation,and difficulty in operation and inadequate hemostasis were risk factors of recurrent hemorrhage(P<(0.05)).Conclusion Appropriate hemostasis in operation and postoperative blood pressure control are important meanings in preventing recurrent hemorrhage.