高血压基底节区脑出血手术患者预后相关因素分析

目的探讨高血压基底节区脑出血手术患者预后相关因素及其意义。方法对80例高血压基底节区脑出血手术患者进行回顾性分析,并分析各临床指标与预后的关系。患者预后以随访6个月时GOS评分评定:1-2分为预后不良,3-5分为预后较好。结果患者预后较好43例,预后不良37例。单因素分析示:GCS评分、脑内血肿量、脑疝、脑出血破入脑室、手术方式、术中出血量、术后残余血肿量、肺部感染、应激性胃溃疡出血、电解质紊乱10项与预后显著相关。Logistic回归分析示:脑疝(P=0.002,OR=9.000,95%CI 2.269-35.701)、术前GCS评分(P=0.023,OR=1.335,95%CI 1.040-1.715)为影响预后的独立相关因素。结论高血压基底节区脑出血手术预后相关因素主要有脑疝、术前GCS评分,了解这些因素有助于临床医生做出合理的治疗决策。

Analysis of prognosis related factors in surgical practices for hypertensive basal ganglia hemorrhage

Objective To explore the prognostic factors in surgical practices for hypertensive basal ganglia hemorrhage(HBGH).Methods The clinical data of 80 cases of hypertensive basal ganglia hemorrhage were analyzed retrospectively.The correlation of clinical features and the prognosis was analyzed.The prognostic outcomes were assessed according to GOS scale after 6-month follow-up.GOS scores 3-5 were defined good outcomes,and 1-2 scores were defined as poor outcomes.Results Among 80 cases,43 cases achieved good outcomes and 37 cases got poor outcomes.The results of univariate analysis showed that there were 10 variables related to the prognostic outcomes,including preoperative GCS score,volume of the intracerebral hematoma,intraventricular hematoma,brain hernia,surgical ways,operative hemorrhage,residual hematoma,pneumonia,hemorrhage of stress ulcer and electrolyte disturbance.Significant factors selected by univariate analysis were further evaluated by logistic regression analysis with forward stepwise selection procedures.Only 2 predictors showed statistical significance in the multivariate analysis,including brain hernia(P=0.002,OR=9.000,95%CI 2.269-35.701),preoperative GCS scores(P=0.023,OR=1.335,95%CI 1.040-1.715).Conclusion The related factors of operative prognosis could be helpful for doctors to make a correct decision for treating patients with HBGH.