微创颅内血肿抽吸术再出血影响因素的Logistic回归分析

Influencing factors of rebleeding after minimally invasive aspiration for intracerebral hematoma byLogistic regression analysis

目的分析微创颅内血肿抽吸术再出血原因，探讨手术适应证，预防再出血。方法归纳252例幕上脑出血行微创血肿抽吸术患者的临床资料，对多个危险因素进行单因素X2检验及多因素Logistic回归分析。结果单因素分析显示，凝血功能、出血病因、出血部位、血肿形状、脑中线移位、破入脑室、穿刺定位、首次抽吸量、手术时机共九个危险因素与再出血有显著相关性（P〈0．05。0．01）。多因素Logistic回归分析显示，凝血功能、血肿形状、手术时机与再出血关系最为密切。结论凝血功能异常、血肿形状不规则、超早期手术是微创颅内血肿抽吸术再出血的重要危险因素。

Objective To analyse the reasons of rebleeding after minimally invasive aspiration for intracerebral hematoma, and to study operative indications and to investigate the prevention methods. Methods 252 cases with aspiration for intracerebral hematoma after supratentorial intracerebral hemor- rhage were analyzed by single factor X2 test and multiple Logistic regression analysis. Results Single factor X^2 test showed there was significant correlation between the rebleeding and nine risk factors, including coagulation function, the causes of hemorrhage, bleeding sites, hematoma shape, intracranial midline shift, hemorrhage broke into brain ventricles, puncture location, aspiration volume at the first time and operation time. Multiple Logistic regression analysis showed that three risk factors had the closest correla- tion with rebleeding, including coagulation function, hematoma shape and operation time. Conclusions Abnormal coagulation function, irregular hematoma shape and super - early operation are important risk factors of rebleeding after minimally invasive aspiration for intracerebral hematoma.