ICH评分量表对估计高血压性脑出血30天死亡率的研究

Intra-cerebral score predicting 30-day mortality rate of patients with intra-cerebral hemorrhage in China

目的 判断脑出血评分量表能否准确估计我国高血压性脑出血患者30天的死亡率.方法 回顾性分析2013年1月～2014年1月我院神经外科304例高血压脑出血住院患者的临床资料.收集患者的年龄、性别、血肿量大小、血肿位置、脑室是否出血、GCS、是否手术以及发病后30天的死亡率情况.结果 ICH评分为0、1、2、3、4、5的高血压性脑出血患者30天的死亡率分别为0（0.0％）、8.9％、23.5％、52％、72％和100％.ICH评分与30天死亡率呈正相关（P＜0.05）.对于幕上血肿≥30ml、幕下血肿≥10ml的高血压性脑出血患者,手术治疗可以明显降低30天的死亡率（P＜0.05）.结论 ICH可以准确估计高血压性脑出血患者30天的死亡率,且简单易行,应在我国推广应用.对于幕上血肿≥30ml、幕下血肿≥10ml的高血压性脑出血患者,应尽早行手术治疗.

Objective To predict the 30-day mortality of patients with intra-cerebral hemorrhage through intra-cerebral hemorrhage score.Methods Patients with hypertensive intra-cerebral hemorrhages were treated in Department of Neurosurgery,West China Hospital.The age,hematoma volume,intra-ventricular haemorrhage,Glowsgow Coma Scale,intra-cerebral haemorrhage score and the treatments of patient were retrospectively reviewed.The outcome was evaluated by the 30-day mortality rate.Results The 30-day mortality rate of patients with intra-cerebral hemorrhage was significantly correlated intra-cerebral score （P〈0.05）.Patients with hypertensive intra-cerebral hemorrhage and supratentorial hematoma volume ≥ 30ml or infratentorial hematoma volume ≥ 10ml could benefit from surgical removal of hematoma （P〈0.05）.Conclusion Intra-cerebral hemorrhage score could accurately predict the 30-day mortality rate of patients with hypertensive intra-cerebral hemorrhage in china.It should be used widely in clinic.