高血压脑出血血肿周围水肿的危险因素分析

Risk factors of edema around the hematoma in hypertensive cerebral hemorrhage

目的：探讨高血压脑出血血肿周围水肿的危险因素，为临床治疗方案的制定提供参考。方法回顾性分析118例高血压脑出血患者的临床资料，采用多因素非条件Logistic回归分析，探讨高血压脑出血血肿周围水肿的危险因素。结果多因素非条件Logistic回归分析结果显示，病程是高血压脑出血血肿周围水肿的危险因素，病程越长，高血压脑出血血肿周围水肿扩大的风险越大。而性别、年龄、出血部位、破入脑室均与高血压脑出血血肿周围水肿无明显的相关性。舒张压是高血压脑出血血肿周围水肿的危险因素，舒张压控制不佳，高血压脑出血血肿周围水肿扩大的风险增大。而收缩压、脉压差均与高血压脑出血血肿周围水肿无明显的相关性。使用氨氯地平、血管紧张素转化酶抑制剂是高血压脑出血血肿周围水肿的保护因素，早期应用氨氯地平、血管紧张素转化酶抑制剂控制血压有助于缩小高血压脑出血血肿周围水肿的体积。而甘露醇、甘油果糖、尼莫地平均与高血压脑出血血肿周围水肿无明显的相关性（均P＞0．05）。结论氨氯地平、血管紧张素转化酶抑制剂的使用有助于缩小高血压脑出血血肿周围水肿的体积，而病程长、舒张压控制不佳可促进高血压脑出血血肿周围水肿体积的增加。临床应重视高血压脑出血降压方案的制定以及舒张压的控制，尽快稳定患者病情，避免血肿周围水肿体积的扩大。

Objective To investigate the risk factors of cerebral hemorrhage in hypertensive intracerebral hemorrhage,and to provide a reference for clinical treatment.Methods The clinical data of 118 patients with hyper-tensive cerebral hemorrhage treated in our hospital were analyzed retrospectively.The clinical data of patients was col-lected and statistical analysis was carried out,and the risk factors of edema around the hematoma were analyzed by Logistic regression analysis.Results Multivariate non conditional logistic regression analysis showed that,the course of hypertensive cerebral hemorrhage of edema around the hematoma was the risk factor,the longer the duration,the more risk of hypertensive cerebral hemorrhage edema around the hematoma enlargement.There was no significant correlation between sex,age,bleeding site,broken into ventricles and the edema around the hematoma in hypertensive intracerebral hemorrhage.Diastolic blood pressure was a risk factor for the edema around the hematoma in hypertensive cerebral hemorrhage,the diastolic blood pressure control was not good,and the swelling of the edema around the hema-toma was increasing.While the systolic blood pressure,pulse pressure difference and hypertensive cerebral hemorrhage hematoma around the hematoma showed no obvious correlation.Use of amlodipine and vascular tension angiotensin converting enzyme inhibitor in hypertensive cerebral hemorrhage were the protective factors of edema around the hematoma, early application of amlodipine,vascular and nervous angiotensin converting enzyme inhibitor to control blood pressure helped to reduce hypertensive cerebral hemorrhage edema around the hematoma volume.Conclusion Amlodipine and vascular tension angiotensin converting enzyme inhibitors help to reduce hypertensive cerebral hemorrhage edema around the hematoma volume,while long course,poor control of diastolic blood pressure can promote hypertension cerebral hemorrhage edema around the hematoma volume increase.We should pay attention to the development of hypertensive cerebral hemorrhage and the control of diastolic blood pressure,as soon as possible to stabilize the patient＇s condition and avoid the expansion of the volume of edema around the hematoma.