微创幕上血肿抽吸引流术后患者死亡相关因素分析

目的探讨幕上脑出血患者行微创血肿抽吸引流术预后的影响因素。方法回顾性分析2009年1月~2013年1月我科采用微创颅内血肿抽吸引流术治疗的129例幕上脑出血患者的临床资料,并对可能影响其预后及死亡的相关因素进行单因素和多因素分析。结果术后死亡16例(12.4%)。单因素分析结果显示患者术前血肿体积(P=0.021或P=0.013)、GCS评分(P=0.011)、糖尿病史(P=0.045)及高血压病史(P=0.039)是影响预后的相关因素,多因素分析显示术前GCS评分(≤8)是患者术后死亡的独立危险因素。结论术前GCS评分≤8是预测幕上脑出血患者血肿抽吸引流术术后死亡风险的独立危险因素,应根据患者意识状态合理选择治疗方案。

The Risk Factors of Postoperative Mortality Associated with Minimally Invasive Hematoma Aspiration Drainage in the Patients with Supratentorial Intracerebral Hemorrhage

Objective To discuss the influence factors of post-operative mortality associated with mini- mally invasive hematoma aspiration drainage in the patients with supratentorial intracerebral hemorrhage （SIH）. Methods The clinical data of 129 SIH patients underwent minimally invasive hematoma aspiration drainage admitted from January 2009 to January 2013 were retrospectively analyzed. Univariate analysis and multiplicity were applied to determine the related influence factors of prognosis and mortality after the micro-invasive surgery. Results Out of the 129 intracranial hematoma cases, a total of 16 cases died with the death rate of 12.4%. Univariate analysis revealed preoperative hematoma volume （P = 0.021 or 0. 013 ）, GCS score （ P = 0.011 ）, complicated diabetes mellitus （ P = 0.045 ） and complicated hypertension （ P = 0. 039 ） were the related prog- nostic factors. Logistic regression analysis showed preoperative GCS score （ ≤8 ） was an independent risk factor of postoperative mortality. Conclusion Preoperative GCS score （≤8） is an independent risk factor for pre- dicting the death of supratentorial intraeerebral hemorrhage patients after hematoma aspiration drainage surgery.