脑出血患者急性期血肿扩大的危险因素研究

Study on the risk factors of hematoma enlargement in patients with intracerebral hemorrhage at acute stage

目的探讨脑出血患者急性期血肿扩大的危险因素。方法将104例脑出血患者分为对照组（血肿未扩大组）和观察组（血肿扩大组），各52例。比较两组病程、平均动脉压、首次出血量、血肿形态以及病死率，分析脑出血患者血肿扩大的危险因素。结果（1）两组病程、平均动脉压、血肿形态以及出血量差异均有统计学意义（t=9．5431、11．4499、6．1847、10．7233，均P〈0．05）；（2）多元Logistic回归分析显示影响血肿扩大的因素是平均动脉压、病程和血肿形态；（3）观察组病死率为36．53％，显著高于对照组的19。23％（X^2=3．8731，P〈0．05）。结论平均动脉压升高、病程缩短、血肿形态不规则是脑出血患者早期发生血肿扩大的主要危险因素，对脑出血患者早期发生血肿扩大具有一定的诊断意义。

Objective To investigate the related risk factors referred to hematoma enlargement in acute stage of spontaneous cerebral hemorrhage. Methods 104 stroke patients were divided into the observation group （hematoma enlarged group）and control group（ without hematoma enlarged group）. The course of disease, mean arterial pressure, the bleeding amount of the first time, hematoma shape and mortality were compared between the two groups, and the risk factors of hematoma enlargement of cerebral hemorrhage patients were analyzed. Results （ 1 ） The course of dis- ease,mean arterial pressure, hematoma shape and the bleeding amount were significantly different between the two groups（ t = 9. 5431,11. 4499,6. 1847,10. 7233, all P 〈 0.05 ）. （ 2 ） The multivariate logistic regression analysis showed that factors of influence on hematoma enlargement were mean arterial blood pressure, the course of disease and hematoma shape. （3）The mortality of the observation group was 36.53% , which was significantly higher than that of the control group （ 19.23 % ） （ X^2 = 3. 8731, P 〈 0.05 ）. Conclusion High level of mean arterial blood pressure, short time of interval to onset, irregular shape of hematoma and frequent vomiting are main risk factors of hematoma enlarge- ment in patients with intracerebral hemorrhage at acute stage.