外伤性急性颅内出血后血肿扩大的危险因素探讨

Study of Risk Factors for Hematoma Enlargement Following Traumatic Acute Intracranial Hemorrhage

【目的】探讨外伤性急性颅内出血(TAICH)后血肿扩大的危险因素。【方法】CT动态观察93例 TAICH患者,分为血肿扩大组和非血肿扩大组,应用单因素和多因素分析方法对有关因素进行分析。 【结果】单因素分析显示,老年人、伤后至首次CT间隔1h内、高血压、长期饮酒、脑内不规则形出血、血肿量 ≥20ml与血肿扩大相关(P<0.05)。Logistic回归分析表明,凝血功能障碍(OR=7.25,95%CI=3.812～ 14.173)和脑内点片状出血(OR=2.56,95%CI=1.095～5.994)与血肿扩大密切相关。【结论】老年人、伤后 至首次CT1h内、高血压、长期饮酒、脑内不规则形出血、血肿量≥20ml是血肿扩大的危险因素。凝血功能障 碍和脑内点片状出血是血肿扩大的主要危险因素。

ObjectiveTo explore the hematoma enlargement risk factors after traumatic acute intracranial hemorrhage.Ninty-three patients of head injury with acute intracranial hemorrage were observed by CT scanning. The patients were divied into hematoma enlargement and non-enlargement group. Univariate and multivariate analyses were used to explore the hematoma enlargement risk factors.Single factor analysis identified the following risk factors:age>60,interval between the injury and primary CT within 1h,hypertension,long term drinking wine ,intracerebral irregular shape hemorrhage and hamatoma volume ≥20 ml were associated with hematoma enlargemant(P<0.05). In Logistic regression significant associations with hematoma enlargement were coagulation disorder(OR=7.25,95%CI=3.812~14.173)and intracerebral multifocal hemorrhage(OR=2.56,95%CI=1.095~5.994).[Conclusion]Besieds single factor analysis significant for hematoma enlargement,coagulation disorder and intracerebral multifocal hemorrhage are also the main risk factors for hematoma enlargement.