高血压性脑出血血肿扩大相关因素分析

目的探讨高血压性脑出血后血肿继续扩大的相关因素。方法回顾性分析187例高血压性脑出血病例的临床资料,其中56例出现血肿持续扩大,将其与未出现血肿扩大者进行对比分析。结果①单因素logistic回归分析显示高血压病程、长期饮酒、糖尿病史、长期服用阿司匹林、体重指数高、发病至第一次CT时间短(<2h)、丘脑出血、血肿形态不规则、入院时血压值高、高血糖和早期大量使用甘露醇是高血压性脑出血后血肿扩大的危险因素;②多因素logistic回归分析显示长期饮酒、长期服用阿司匹林、发病至第一次CT时间短(<2h)、丘脑出血、血肿形态不规则、入院时血压值高和早期大量使用甘露醇是高血压性脑出血血肿扩大的独立危险因素。结论对长期饮酒、长期服用阿司匹林、丘脑出血、血肿形态不规则、入院时血压值高以及出血后大量使用甘露醇的高血压性脑出血患者要严密观察病情变化,高度警惕血肿继续扩大以免延误治疗。

Analysis of factors related to intracerebral hematoma enlargement in patients with hypertensive cerebral hemorrhage

Objective To investigate the factors related to intracerebral hematoma enlargement after hypertensive intracerebral hemorrhage.Methods The clinical data of 187 patients with hypertensive cerebral hemorrhage,of whom,56 underwent enlargement of the intracerebral hematoma and 131 did not,were analyzed retrospectively.Results Univariate-factor logistic regression analysis showed that the factors related to hematoma enlargement included long duration of hypertension,long-term drinking,history of diabetes,long-term administration of the aspirin,high body mass index(BMI),short time from onset to first CT examination(<2 h),thalamic hemorrhage,irregular hematoma,increase in the blood pressure on admission,high blood glucose levels and early heavy infusion of mannitol in patients with hypertensive intracerebral hemorrhage.Multivariable regression analysis showed that the factors related to the enlargement with intracerebral hemorrhage included long-term drinking,long-term administration aspirin,short time from onset to first CT examination(<2 h),thalamic hemorrhage,irregular hematoma,increase in the blood pressure on admission and early heavy infusion of mannitol in the patients with hypertensive cerebral hemorrhage.Conclusions The disease conditions including the change in the intracerebral hematomas should be closely observed in order to avoid delay of treatment in the hypertensive cerebral hemorrhage patients with long-term drinking,long-term administration of the aspirin,the thalamic hemorrhage,irregular hematoma,increase in the blood pressure on admission and heavy infusion of mannitol early after the hemorrhage.