幕上自发性脑内出血后迟发性癫癇发作的危险因素分析

Risk factors for late seizure after supratentorial spontaneous intracranial hemorrhage

目的探讨幕上自发性脑内出血(spontaneous intracranial hemorrhage,SICH)的继发迟发性癫癇的相关危险因素。方法回顾性分析170例幕上SICH病人的临床资料,根据是否发生迟发性癫癇,将病人分为迟发性癫癇组(n=11)和无迟发性癫癇组(n=159)。对迟发性癫癇发作的相关因素进行统计分析。结果单因素分析表明:发病年龄、皮质出血、出血量、高血压病和早期癫癇发作与幕上SICH病人继发迟发性癫癇显著相关(P<0.05)。多因素分析结果表明:发病年龄(OR=0.87,95%CI=0.76~0.95,P=0.023)和皮质出血(OR=2.81,95%CI=1.49~4.65,P=0.010)是迟发性癫癇的独立危险因素。结论幕上SICH术后要注意迟发性癫癇的发生,特别是年龄偏小和和皮质出血的病人。

Objectives To investigate the risk factors for secondary late seizure of supratentorial spontaneous intracranial hemorrhage （SICH）. Methods Clinical data of 170 patients with supratentorial SICH were analyzed retrospectively. According to late seizure occurring or not, the patients were divided into late seizure group （n = 11） and non late seizure group （n = 159）. The related factors for late seizure were analyzed statistically. Results Univariate analysis showed that age of onset, cortical hemorrhage, blood loss, hypertension disease and early seizure were significantly related with late seizure of supratentorial SICH patients （P 〈 0.05）. Further multivariate analysis showed that the age of onset （OR = 0.87, 95% CI = 0.76 to 0.95, P = 0.023） and cortical hemorrhage （OR = 2.81, 95%CI = 1.49 to 4.65, P = 0.010） were the independent risk factors of late seizure. Conclusion The late seizure should be noticed after surgery of supratentorial SICH, especially for patient with lower age and cortical hemorrhage.