影响青年高血压性脑出血预后的相关因素分析

Relative factors affecting the prognosis of young patients with hypertensive cerebral hemor- rhage

目的：分析影响青年高血压性脑出血预后的相关因素。方法：收集整理45例已接受开颅手术的青年高血压性脑出血患者的病历资料，根据患者死亡情况和手术30d后格拉斯哥昏迷量表（GCS）评分将所有患者分为两组，术后30dGCS评分大于术前的患者归为好转组，术后死亡或术后30dGCS评分小于等于术前者归为未好转组，统计两组患者年龄、性别、体质量、出血量、出血部位、术前GCS评分、是否破入脑室、是否合并脑疝、最高收缩压、血肿清除率等资料，分析这些因素与患者预后的联系。结果：出血量、术前GCS评分、出血破人脑室、合并脑疝、术前最高收缩压等为患者预后的危险因素（x2值相应分别=4．430、0．792、-8．432、13．500、6．497、1．687，P〈0．05）。结论：高血压性脑出血发病前积极控制血压、对符合手术指征的青年高血压性脑出血患者积极手术能改善患者的预后。

Objective： To analyze the main factors that influence the prognosis of young patients with hypertensive cerebral hemorrhage. Methods：To collect the clinical data of 45 cases of young patients with hypertensive cerebral hemorrhage who had received craniotomy operation. All the patients were di- vided into two groups according to the survival status and Glasgow coma scales（GCS） scores 30 days after operation. Patients with higher GCS scores than the preoperative were in the recovered group, and patients with the same or lower GCS scores than before operation or dead ones after operation were in the non--recovered group. Then the information about age, sex, weight, hemorrhage volume, location of hemorrhage, preoperative GCS scores, hemorrhage in ventricle, brain hernia, maximum systolic pres- sure,and hemorrhage removal ratio of the patients were collected, and the relationship between factors a bove mentioned and the prognosis of patients were analyzed. Results： Hemorrhage volume, preoperative GCS scores, hemorrhage in ventricle, brain hernia and maximum systolic pressure affected the prognosis of patients. Conclusion：In order to control the blood pressure before pathogenesis of hypertensive cere- bral hemorrhage and early operation to the patients with surgical indication can improve the prognosis of young patients with hypertensive cerebral hemorrhage.