急性脑出血74例临床特点及血肿扩大相关因素分析

Clinical Characteristics of 74 Patients with Acute Cerebral Hemorrhage and Related Factors of Hematoma Enlargement

目的观察急性脑出血患者临床特点,并分析血肿扩大相关影响因素。方法选取2014年7月—2017年6月收治的急性脑出血74例,均于发病6、48 h内行头颅CT检查,依据CT检查结果分为血肿扩大组和血肿未扩大组。比较2组临床特征,分析急性脑出血患者血肿扩大的危险因素。结果 74例急性脑出血患者有规则血肿36例、不规则血肿38例,均质血肿50例、不均质血肿24例,血肿形状和均质性以Ⅱ级最常见。74例急性脑出血患者共16例血肿扩大,58例血肿未扩大,血肿扩大率21. 62%。糖尿病史、入院3 h收缩压升高和不均质血肿是急性脑出血患者血肿扩大的独立危险因素(P <0. 05)。结论急性脑出血患者临床特点具有特征性,其血肿扩大的独立危险因素为糖尿病史、入院3 h收缩压升高和不均质血肿,临床工作中应严密监测患者血糖、血压变化,积极实施合理防治措施。

Objective To observe clinical characteristics of patients with acute cerebral hemorrhage and analyze related influencing factors of hematoma enlargement.Methods A total of 74 patients with acute cerebral hemorrhage admitted during July 2014 and June 2017 underwent skull CT examination within 6h and 48h after attack,and the patients were divided into hematoma enlargement group and non-hematoma enlargement group according to CT findings.In two groups,clinical characteristics were observed,and risk factors of hematoma enlargement in patients with acute cerebral hemorrhage were analyzed.Results There were 36 patients with regular hematoma,38 patients with irregular hematoma,50 patients with homogeneous hematoma and 24 patients with heterogeneous hematoma in 74 patients with acute cerebral hemorrhage.The most common shape and homogeneity of hematoma were grade II.Among 74 patients with acute cerebral hemorrhage,there were 16 patients with hematoma enlargement and 58 patients without hematoma enlargement,and hematoma enlargement rate was 21.62%.History of diabetes mellitus,increasing level of systolic blood pressure(SBP)within 3h after admission and heterogeneous hematoma were independent risk factors of hematoma enlargement in patients with acute cerebral hemorrhage(P<0.05).Conclusion Clinical characteristics of patients with acute cerebral hemorrhage are clear,and independent risk factors of hematoma enlargement are history of diabetes mellitus,increasing SBP level within 3h after admission and heterogeneous hematoma,and therefore clinicians should closely monitor changes of blood glucose and blood pressure and actively give reasonable prevention measures.