幕上自发性脑内出血62例外科治疗预后影响因素分析

A Retrospective Study of the Influential Factors in 62 Surgical Patients with Spontaneous Intracerebral Hemorrhage

目的：探讨幕上白发性脑内出血不同外科治疗措施预后的主要影响因素。方法：本组共计62例，男37例，女25例。所有患者均经头颅CT扫描检查确诊为基底节区出血，专科医生根据患者住院时情况及经验决定外科治疗方案，分别采用传统开颅内血肿清除外减压手术，显微微创手术和钻孔引流尿激酶溶解术。治疗结果以患者出院时情况进行评判，标准采用ADL日常能力分级，Ⅰ级～Ⅱ级为预后良好，Ⅳ级～Ⅴ级为预后不良，住院期间死亡患者排除在本次统计之外。使用SPSS for Windows11．5统计软件包，应用Logistic回归分析统计学方法对结果进行处理，P〈0．05为有统计学意义。结果：经统计学处理，年龄（B=-0．187，P=0．001），意识水平（B=0．322，P=0．004），出血量（B=-0．041，P=0．000），脑室铸型（B=2．185，P=0．037）为影响该组预后的主要因素。结论：年龄、意识水平、出血量、脑室铸型是影响幕上自发性脑内出血预后的重要因素。

Objective： To study the influential factors in surgical patients with spontaneous intracerebral hemorrhage（SICH）. Method： 62 Cases with SICH treated with minimally invasive surgery, microsurgery and traditional craniotomy were retrospective analyzed. All the diagnosis were supported by computerized tomography （CT） and the treatment decisions were made by specialist in Neurosurgery. The final results were evaluated among the discharged patients baaed on ADL scale except the deaths. ADLI - HI were better and Ⅳ - Ⅴ were bad. Statistics method was Logistic regression in SPSS for Windows 11.5. Result： The sig- nificant factors were age （ = - 0.187, p = 0.001 ）, GCS （ B = 0.322, p = 0. 004 ） , volume of hemorrhage （ B = -0.041 ,p =0.000） and cast form of ventricle （ B =2. 185,p =0.037） by statistical treatment. Conclusion： Age, GCS, volume of hemorrhage and cast form of ventricle were the most important influential factors in the patients with spontaneous intracerebral hemorrhage（ SICH）.