抗凝治疗中颅内出血相关因素分析

Analysis of relative factors of intracraniai hemorrhage during anticoagulation therapy

目的探讨应用抗凝药物治疗中有关颅内出血的危险因素，总结应用抗凝药过程中颅内出血救治的经验教训。方法回顾性分析5例在应用抗凝药物过程中发生颅内出血的临床特征，治疗经过和结果。结果5例颅内出血患者均合并基础疾病，GOS评分1分者（死亡）3例，3分者（重残）1例，5分者（良好）1例。颅内出血中3例为硬膜下血肿，2例为脑内血肿。3例患者分别在意识改变后4h、3d、6d死亡。结论抗凝治疗中发生颅内出血的病情变化快、死亡率高，对患者的危险性认识往往不足。高龄、高INR、外伤史、合并基础疾病是预后不良的主要危险因素。

Objective To study the risk factors and experience in the treatment of intracranial hemorrhage（ICH） in patients with anticoagulation therapy. Method The clinical characters, treatment process, and the results of 5 cases with ICH during anticoagulation therapy were analyzed retrospectively. Results 5 cases all combined with intrinsic diseases. 3 patients achieved a Glasgow Outcome Score of 1, 1 patient achieved 3,and 1 achieved 5. In the 5 cases, 3 cases suffered from subdural hemorrhage, 2 cases brain hemorrhage. 3 died at 4 hours,3 days,6 days respectively after loss of consciousness. Conclusions The state of illness is changed quickly in ICH during anticoagulation therapy , and the mortality is high. Senility, high INR value, traumatic history and intrinsic diseases are main risk factors of bad prognosis.