高血压脑出血患者术后再出血危险因素分析

Analysis of related factors of postoperative hemorrhage after hypertensive intracerebral hemorrhage

目的探讨高血压脑出血患者术后再出血的危险因素。方法选择2009年1月—2015年2月收治的高血压脑出血患者712例,根据术后是否再出血进行分组,术后再出血的116例为出血组,术后未出血的596例为未出血组,采用多因素Logistic回归模型分析术后再出血的危险因素,P<0.05为差异有统计学意义。结果多因素非条件Logistic回归分析结果显示,高血压脑出血术后再出血的危险因素包括术后血压波动(OR=9.864)、出血至手术时间(OR=7.186)、术中止血困难或止血不彻底(OR=6.127)。结论在外科手术治疗高血压脑出血中,应尽快手术、做好术中止血、术后确保血压稳定是预防术后再出血的关键措施。

Objective To explore risk factors of postoperative rebleeding of patients with hypertensive intracerebral hemorrhage. Methods A total of 712 cases of hypertensive intracerebral hemorrhage choosed from January 2009 to February 2015 were grouped according to whether postoperative bleeding, 116 cases of bleeding after operation were hemorrhage group, 596 cases without bleeding after operation were non hemorrhage group. The multiple factor Logistic regression model was used to analyze the risk factors for postoperative rebleeding.Results The risk factors for postoperative rebleeding after hypertensive intracerebral hemorrhage include postoperative blood pressure fluctuation（OR=9.864）, bleeding to operative time（OR=7.186）, difficulty in hemostasis or incomplete hemostasis（OR=6.127）.Conclusion In surgical operation for hypertensive intracerebral hemorrhage, operation as soon as possible, hemostatic operation during operation and postoperative stable blood pressure are the key measures to prevent postoperative rebleeding.