高血压脑出血血肿扩大的危险因素

Risk factors of hematoma enlargement after hypertensive intracerebral hemorrhage

目的:探讨高血压脑出血血肿扩大的危险因素。方法:对我院2009年1月-2010年12月122例高血压脑出血患者为研究对象,发病后6 h内及48 h内进行头颅CT检查,根据头颅CT检查结果分为血肿扩大组和非血肿扩大组。分析2组平均动脉压、首次CT检查血肿体积及血肿形态、血肿位置、凝血功能、渗透性利尿剂使用情况。结果:血肿扩大组平均动脉压、首次CT检查血肿体积分别为(142.75±19.69)mmHg、(18.70±6.25)ml,明显高于非血肿扩大组的(121.08±18.98)mmHg、(13.10±4.99)ml(P<0.05);血肿扩大组血肿形态不规则、凝血功能障碍及渗透性利尿剂早期使用发生率也明显高于非血肿扩大组(P<0.05),血肿位置对血肿扩大无显著影响(P>0.05)。结论:高平均动脉压、首次CT检查血肿体积、血肿形态不规则、凝血功能障碍、渗透性利尿剂早期使用可能与高血压脑出血血肿扩大有关。

Objective：To explore the risk factors of hematoma enlargement after hypertensive intracerebral hemorrhage.Methods：122 patients with hypertensive intracerebral hemorrhage were analyzed,who came to our hospital from January 2009 to December 2010.Cranial CT scan within 6 hours and 48 hours was performed respectively after intracerebral hemorrhage.All patients were divided into hematoma enlargement group and non-hematoma enlargement group by head CT findings.Blood pressure within 24 hours after admission and mean arterial pressure,the first hematoma volume,hematoma shape,hematoma location,coagulation,and the use of osmotic diuretics were detected and analyzed.Results：Mean arterial pressure and the first hematoma volume（142.75 mmHg±19.69 mmHg,18.70 ml±6.25 ml） were significantly increased in hematoma enlargement group compared with non-hematoma enlargement group（121.08 mmHg±18.98 mmHg,13.10 ml±4.99 ml）.The patients in hematoma enlargement group showed higher incidence than non-hematoma enlargement group in irregular hematoma shape,coagulation disorders and early use of osmotic diuretics.Hematoma location had no significant effect on hematoma enlargement.Conclusion：High mean arterial pressure,the first hematoma volume,irregular hematoma shape,coagulation dysfunction and early use of osmotic diuretics may be related to the hematoma enlargement after hypertensive intracerebral hemorrhage.