高血压脑出血微创术后再出血的临床多因素分析

Clinical multi-factors＇analysis on rebleeding of hypertensive hemorrhage after minimally invasive craniopunc- ture

目的探讨影响高血压脑出血微创术后再出血的因素及防治策略。方法回顾性分析213例使用微创穿刺血肿清除技术治疗的高血压脑出血病例，对8个可能影响术后再出血的因素进行统计，使用Logistic回归分析选出影响术后再出血的危险因素。结果27例出现术后再出血，血肿形状（β=2．236，P=0．002）、入院时收缩压（β=1．877，P=0．001）、手术时机（β=-1．589，P=0．004）、术中抽吸血肿量（β=1．280，P=0．010）是影响微创术后再出血的主要因素。结论重视血肿形状、入院时收缩压、手术时机、术中抽吸血肿量对微创术后再出血的影响，针对不同患者作个性化的防治策略，有助于减少高血压脑出血微创术后再出血的发生率。

Objective To investigate the clinical factors and therapeutic tactic for rebleeding; of hypertensive hemorrhage after minimally invasive craniopuncture. Methods Clinical data of 213 cases were reviewed retrospec- tively. 8 possible factors were gathered to select the highTrisk ones by multiple-factor Logistic regression analysis. Results 27 cases bled after minimally invasive craniopuncture therapy. By Logistic regression analysis, we found 4 high-risk factors of recurrence hemorrhage, including hematoma shape（β = 2. 236 ,P = 0. 002 ） , systolic blood pressure on admission（β= 1. 877, P = 0.001 ） , operation time （β = - 1. 589, P = 0. 004 ）and hematoma clearance （β = 1. 280, P = 0.010）. Conclusion Paying more attention to the 4 factors and treating each patient by individual therapeutic tactic according to the 4 factors will help to decrease the incidence of bleeding after minimally invasive craniopunc- ture.