联合评分在高血压脑出血预后的评估及手术指征探讨中的应用

目的：评定基于GCS评分、CT及全身情况联合评分方法在临床的可行性和统计学上的合理性，提出基于联合评分的科学、可行的高血压脑出血手术适应证。方法：高血压脑出血住院手术病人共100例，将常见的影响高血压脑出血手术预后的因素与病人预后结合，进行单因素分析，筛选出有统计学意义的因素。每例病例均从GCS、CT和全身状况三方面评分，再将三项得分相加，得出联合评分值。将联合评分值与病人预后相结合，进行统计学分析，检验联合评分法是否合理。结果：单因素分析中，年龄、发病至手术的时间、GCS评分等因素对高血压脑出血手术预后有显影响，而有无脑卒中史则经统计学检验对预后无显性影响。基于联合评分法的四型患预后均有显性差异。结论：GCS评分、CT评分和全身情况联合评分判断高血压出血病人手术预后是可行的，统计学上有意义。

Application of Combined Grading Method in the Evaluation of the Prognosis of Hypertensive Intracranial Hemorrhage and the Surgical Indications

Objective:To evaluate the clinical feasibility and the statistical rationality of the combined grading method based on the GCS scale,CT and general conditions and to determine the surgical indications of the hypertensive intracranial hemorrhage (HIH) based on the combined grading method.Methods:100 cases of hypertensive intracranial hemorrhage were included in this study.Combinding the factors affecting the surgical prognosis with the prognosis of patients with HIH,a single factor analysis was conducted to screen factors with statistical significance.The combined grading method was applied in each case.The grade was combined with the prognosis in the statistical analysis to check the feasibility and the rationality of the combined grading method.Results:Factors such as age,the time between the onset of the disease and operation and GCS scale had remarkable influence on the prognosis.There was significant statistical difference between the four groups divided according to the combined grading method.Conclusion:The clinical feasibility and the statistical rationality of the combined grading method is proved in the evaluation of the surgical prognosis of patients with HIH.