【摘要】 目的探讨影响高血压性脑出血(ICH)微创血肿穿刺引流术后继续出血的危险因素。方法选取在我院神经内科诊断为脑出血,行微创血肿穿刺引流术的患者98例,按术后有无继续出血分为两组,病例组为术后继续出血的患者20例,对照组为术后无继续出血的患者78例,利用SPSS软件对临床资料进行统计学分析。结果①病例组ICH Score、GGT、收缩压(SBP)、血糖(GLU)、每日饮酒量、原发出血量较对照组增高,FIB较对照组降低,P<0.05或<0.01;病例组ALT、AST、舒张压(DBP)、CH、TG、LDL较对照组增高,病例组HDL较对照组降低(P>0.05)。②病例组发病到手术的时间短于对照组(P<0.01)。③病例组血肿形态不规则者高于对照组(P<0.05)。④病例组手术前后躁动不安者较对照组增高(P<0.05)。⑤Spearman’s秩相关分析显示,术后继续出血与ICHScore、GGT、SBP、每日饮酒量、原发出血量、手术前后躁动呈正相关,与发病到手术的时间、血肿形态、FIB呈负相关(P<0.05或<0.01),与GLU无相关性。结论发病后6 h内施行手术、手术前后躁动、术前血压增高、长期酗酒、肝功能异常、低纤维蛋白原水平和血肿形态不规则为微创颅内血肿穿刺术术后继续出血的危险因素。更多还原

【Abstract】 Objective To explore the impact of risk factors for postoperative bleeding in minimally invasive hematoma puncture of hypertensive intracerebral hemorrhage(ICH).Methods A total of 98 patients treated by minimally invasive hematoma puncture were included in the research.All patients after surgery were divided into two groups by bleeding or whether.20 patients with continue bleeding after surgery was the case group,the control group was the 78 patients without bleeding.Clinical data of patients were statistically analyzed by using SPSS statistical analysis software.Results ① ICH Score,GGT,systolic blood pressure(SBP),glucose(GLU),daily alcohol consumption and the original issued amount of blood were higher than those in the control group,but the FIB were decreased,P<0.05 or P<0.01.ALT and AST and diastolic blood pressure(DBP),CH,TG and LDL in the case group were increased compared with the control group,HDL in the case group was decreased(P>0.05).② Time of onset to surgery time in case group was shorter than the control group(P<0.01).③ Hematoma irregular shape in case group was higher than that in the control group(P<0.05).④ Restless patient in case group was increased than that in the control group(P<0.05).⑤ Postoperative bleeding was positive correlated with ICH score,GGT,SBP,daily alcohol consumption,the original issued amount of blood by analyzed by Spearman’s rank correlation analysis.Postoperative bleeding was negative correlated with onset to surgery time,hematoma form,FIB,no correlaiton with GLU.Conclusions Postoperative bleeding in patients given minimally invasive intracranial hematoma puncture is related especially with puncture within 6 hours,the increased SBP and restlessness before and after surgery.While patients with chronic alcoholism,abnormal liver function or low fibrinogen levels are probability of postoperative bleeding.更多还原