高血压性脑出血早期血肿扩大的相关因素研究

目的：探讨脑出血后血肿扩大的相关因素。方法：对155例脑出血患者发病后24h内进行动态CT观察。结果：155例脑出血患者中，有36例发生早期血肿扩大，血肿扩大发生率为23．2％。结论：早期血肿扩大以6h以内为多（占91．67％），早期血肿扩大与血压、出血部位、血肿形状、首次CT血肿量、及早期不适当使用甘露醇有关，而与年龄无关。高血压性脑出血后血肿扩大多发生在24h内，为了降低脑出血的病死率与致残率，凡对发病在24h内高血压性脑出血患者，需要严密观察病情变化，及时予CT复查，以便早期发现有无血肿扩大，争取合理治疗，并合理使用甘露醇。

Correlation factors to early haematoma enlargement after hypertensive cerebral hemorrhage

Objective To explore the correlation factors of haematoma enlargement after hypertensive cerebral hemorrhage.Method The CT images of 155 cases with hypertensive cerebral hemorrhage were observed dynamicly 24 hours after the disease onset.Results Thirty-six cases appeared early haematoma enlargement,and the incidence rate was 23.2%.Early haematoma enlargement occurred mostly within 6 hours after attack(91.67%),and was related to blood pressure,bleed position,shape of haematoma,quantity of haematoma on first time CT,and early improper use of mannitol,but not related to age. Conclusion Haematoma enlargement after hypertensive cerebral hemorrhage often occurs in 24 hours after attack. In order to lower the case fatality and disability rate,for the cases with onset of hypertensive cerebral hemorrhage shorter than 24 hours,we should observe the patient′s condition closely,and recheck CT in time,so that we can find the haematoma enlargement early.Proper use of mannitol is also important.