Factors Influencing Early Prognosis after Surgical Treatment of Supratentorial Hypertensive Intracerebral Hemorrhage_West China Medical Journal

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Department of Neurosurgery, People’s Hospital of Leshan, Leshan Sichuan 614000, China;

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Keywords：

幕上高血压脑出血; 手术; 预后

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目的:探讨幕上高血压脑出血手术治疗近期预后的影响因素。方法:回顾经手术治疗的73例幕上高血压脑出血患者的临床资料,分析患者性别、年龄、术前GCS评分、出血部位、术前瞳孔有无散大、出血是否破入脑室、出血量、手术时机8个因素对患者预后的影响。评定患者日常生活能力(ADL)分级,将ADL 1-3级划为预后良好组,ADL 4-6级划为预后差组。结果:预后良好组和预后差组在术前GCS评分、出血量、出血是否破入脑室、术前瞳孔有无散大及手术时机上在统计学上有显著性差异(P lt;0.05),而患者的年龄、性别及出血部位则在统计学上未见显著性差异(P gt;0.05)。Logistic回归分析,术前GCS评分、出血量、出血是否破入脑室与预后ADL分级相关(P lt;0.05)。其相关系数分别为:-0.456、0.124、0.341。结论:术前GCS评分、出血量、出血是否破入脑室是估计患者手术治疗近期预后有意义的指标,术前瞳孔有无散大、手术时机对评价患者预后有一定的参考价值。了解影响高血压脑出血预后的因素可以更有效的制定治疗方案,估计预后。

Citation： ZHENG Niandong,WEI Zhenghong,WANG Shan,et al.. Factors Influencing Early Prognosis after Surgical Treatment of Supratentorial Hypertensive Intracerebral Hemorrhage. West China Medical Journal, 2009, 24(6): 1351-1353. doi: Copy

1.
2.	BRODERICK J P, BROTT T G, DULDNER J E, et al. Volume of intracerebellal hemorrhage. A powerful and easyto use predictor of 30day mortality[J]. Stroke,1993,24(7):987-993.
3.	AVELLA D, SERVADEI F, SCERRATI M, et al. Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients [J]. Neurosurgery,2002,50(1):16-27.
4.	江普查,袁先厚,黄伟,等.重型高血压脑出血手术治疗后预后影响因素[J].临床外科杂志,2000,8(5):285-286.
5.	沈宏,杨小锋,刘伟国,等.急性硬膜下血肿近期预后因素分析[J].中华神经外科杂志,2002,18(6):402-404.
6.	郑国庆,黄培新.356例高血压幕上脑出血患者28天预后影响因素的分析[J].温州医学院学报,2006,36(1):10-15.
7.	NILSSON O G, LINDGREN A, BRANDT L, et al. Prediction of death in patients with primary intracerebral hemorrhage. A prospective study of a defined population[J]. J Neurosurg,2002,97(3):531-536.
8.	HALLEVI H, ALBRIGHT K C, AONOWSKI J, et al. Intraventricular hemorrhage: anatomic relationships and clinical implications[J]. Neurology,2008,70(11):848-852.
9.	任泽光,吴建中,尹可.高血压脑出血后脑血流及自由基变化规律及其与脑水肿关系[J].中华神经外科杂志,1995,11(2):209.

1.
2. BRODERICK J P, BROTT T G, DULDNER J E, et al. Volume of intracerebellal hemorrhage. A powerful and easyto use predictor of 30day mortality[J]. Stroke,1993,24(7):987-993.
3. AVELLA D, SERVADEI F, SCERRATI M, et al. Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients [J]. Neurosurgery,2002,50(1):16-27.
4. 江普查,袁先厚,黄伟,等.重型高血压脑出血手术治疗后预后影响因素[J].临床外科杂志,2000,8(5):285-286.
5. 沈宏,杨小锋,刘伟国,等.急性硬膜下血肿近期预后因素分析[J].中华神经外科杂志,2002,18(6):402-404.
6. 郑国庆,黄培新.356例高血压幕上脑出血患者28天预后影响因素的分析[J].温州医学院学报,2006,36(1):10-15.
7. NILSSON O G, LINDGREN A, BRANDT L, et al. Prediction of death in patients with primary intracerebral hemorrhage. A prospective study of a defined population[J]. J Neurosurg,2002,97(3):531-536.
8. HALLEVI H, ALBRIGHT K C, AONOWSKI J, et al. Intraventricular hemorrhage: anatomic relationships and clinical implications[J]. Neurology,2008,70(11):848-852.
9. 任泽光,吴建中,尹可.高血压脑出血后脑血流及自由基变化规律及其与脑水肿关系[J].中华神经外科杂志,1995,11(2):209.

West China Medical Journal

Factors Influencing Early Prognosis after Surgical Treatment of Supratentorial Hypertensive Intracerebral Hemorrhage

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