自发性脑出血早期血肿扩大临床预测相关因素分析

Clinical analysis on the correlative factors of early enlargement of hematoma in spontaneus introcerebral hemorrhage

目的探讨自发性脑出血早期血肿扩大的相关因素,使临床医生及早发现,及时治疗,以达到降低死亡率和致残率的目的。方法对2002年3月至2009年5月7年间410例自发性脑出血患者的临床资料、头颅CT动态扫描结果进行回顾性分析。结果自发性脑出血早期血肿扩大与早期临床进行性恶化、早期血压水平、饮酒史、肝肾功能状况、糖尿病史、首次头颅CT检查距发病时间、血肿形态、血肿密度、阿司匹林应用史,发病早期甘露醇应用及发病早期血压管理等密切相关。SICH早期血肿扩大是SICH患者死亡率高的重要原因之一。结论对自发性脑出血患者应尽早进行全面的临床资料分析,密切观察病情的动态变化,适时予以头颅CT扫描复查并及时采取有效治疗措施,可显著改善预后。

Objective To investigate the correlative factors of early enlargement of hematomas in spon- taneous cerebral hemorrhage. Methods The results of dynamic CT examination and clinical data of 410 patients from March 2002 to May 2009 were analyzed retrospectively. Results Continued hemorrhage tendency existed in early stage of spontaneous cerebral hemorrhage. It was the main reason for high mortality rates of SICH pa- tients. The main influence factors included： high blood pressure, drinking history, hepatic and nephric function abnormal, internal of onset to first CT scan, shape of hematomas, the density of the hematomas, aspirin aplica- tion history, early usage of mannitol and blood pressure management. Conclusion To the SICH patients it was necessary to conduct a comprehensive analysis of clinical data in time , and to closely observe the condition of the dynamic change of disease. Head CT scan should be reviewed in the due course and effective treatment me- assure was taken timely. All these can signifiently improve the progonosis of SICH.