脑出血早期血肿扩大危险因素临床分析

目的探讨脑出血24小时内血肿扩大的影响因素。方法回顾性分析102例住院脑出血患者的病历资料，根据头颅CT结果分为血肿扩大组（25例）及非血肿扩大组（77例），对两组患者临床资料、血生化检查资料及头颅CT影像学资料等进行统计学分析。结果脑出血24小时内早期血肿扩大发生率为24．51％。患者的性别、年龄、收缩压、Glasgow评分、NHISS评分、空腹血糖、血肿形态、出血量在两组之间的差异比较有统计学意义（P〈0．05），其中性别、年龄〈60岁、血肿形态、出血量〉32ml、NHISS评分〉20分及入院时收缩压≥200mmHg为影响脑出血24小时内早期血肿扩大有统计学意义的因素。结论女性、年龄≥60岁以及血肿形态规则的脑出血患者，在发病后24小时内发生早期血肿扩大的可能性较小。出血量〉32ml、NHISS评分〉20分及入院时收缩压≥200mmHg可能是影响脑出血24小时内早期血肿扩大的危险因素。

The clinical analysis of risk factors on early hematoma enlargement in cerebral hemorrhage

Objective To detect the factors associated with early hematoma enlargement within 24 hours after cere- bral hemorrhage. Methods 102 admitted caaes of cerebral hemorrhage were retrospectively analyzed, which were divided into hematoma expansion group（25 cases） and non--hematoma expansion group （77 cases） according to brain CT. The statistical analysis was developed on clinical data, serum biochemical tests and the characteristic of hematoma on CT between two groups. Results The incidence of early hematoma expansion within 24 hours was 24. 5%. The parameter of sex, age, systolic pressure, Glasgow Coma Scores, NHISS, fasting blood-glucose, shape of hematoma and amount of bleeding were all significantly different between the two groups （P〈0.05）. Sex, age〈60 years, amount of bleeding〉 32ml, NHISS〉20 and systolic pressure on admission≥200mmHg were the statistical factors of early hematoma expansion within 24 hours in cerebral hemorrhage. Conclusion The incidence of early hematoma expansion within 24 hours is 24.51%. The possibility of early hematoma expansion within 24 hours is small in the patients which are female with age 260 years and a regular shape of hematoma. The amount of bleeding〉32ml, NHISS〉20, systolic pressure on admission≥200mmHg are the risk factors of early hematoma expansion within 24 hours in cerebral hemorrhage probably.