高血压性脑出血继续出血的临床分析

Clinical analysis of continued hemorrhage in hypertensive cerebral hemorrhage

目的:分析高血压性脑出血继续出血的临床致病因素。方法:收治高血压脑出血患者103例,随机分为两组,即继续出血组35例和未再次出血组68例。对比引发患者继续出血的致病因素,再根据患者的致病因素,行针对性治疗。结果:引发高血压性脑出血患者继续出血的临床致病因素有不规则血肿形态、既往有慢性肝病史、卒中病史、长期饮酒以及凝血功能障碍史。行内科保守治疗27例,行去骨瓣脑内血肿清除术或去骨瓣减压术治疗34例,行颅骨钻孔血肿抽吸术配合术后常规引流及尿激酶灌注治疗42例。经治疗后,所有患者的出血情况均得到有效控制,但继续出血组的平均总出血量(57.6±14.8)m L,明显高于未再次出血组患者的(40.2±13.5)m L。结论:引发高血压性脑出血患者发生继续出血的致病因素有多种,且继续出血发生率较高,临床需及时采取针对性的治疗方案对患者进行治疗,才能有效改善患者的出血症状和提高其生存质量。

Objective：To analyze the clinical pathogenic factors of continuous hemorrhage caused by hypertensive cerebral hemorrhage.Methods：103 patients with hypertensive intracerebral hemorrhage were randomly divided into the two groups,the continuous bleeding group with 35 cases and the non-rebleeding group with 68 cases.We compared the pathogenetic factors that caused continue bleeding,and then based on the patient＇s pathogenic factors to made targeted therapy. Results：The clinical pathogenic factors that caused bleeding in patients with hypertensive cerebral hemorrhage were irregular hematoma morphology,history of chronic liver disease,history of stroke,long-term alcohol consumption,and the history of coagulation dysfunction.27 patients underwent conservative treatment in the department of internal medicine,34 patients underwent intracerebral hematoma removal or decompressive decompressive craniectomy for bone flaps,42 cases of patients with cranial drilling hematoma aspiration combined with routine postoperative drainage and urokinase infusion therapy.After that treatment,the bleeding was effectively controlled in all patients,but the total mean bleeding volume（57.6±14.8）mL in the continuous bleeding group was significantly higher than that in the non-rebleeding group（40.2±13.5）mL.Conclusion：There are many pathogenic factors causing continuous hemorrhage in hypertensive intracerebral hemorrhage patients,and the incidence of continuous hemorrhage is high.Clinically,it is necessary to take timely targeted treatment plans to treat patients in order to effectively improve the hemorrhagic symptoms of patients and improve the quality of life.