高血压脑出血患者颅内血肿周围水肿体积扩大的影响性因素研究

Analysis of factors affecting intracranial hematoma and increased perihematomal edema volume in patients with hypertensive cerebral hemorrhage

目的探究高血压脑出血患者颅内血肿周围水肿体积扩大的影响性因素。方法选取2018年1月~2019年1月于我院诊疗的高血压性脑出血患者76例,依据患者水肿扩大情况分为两组,对照组为水肿未扩大者38例,研究组为水肿扩大者38例。比较两组患者一般资料及相关影响性因素。结果两组的性别及年龄比较差异无统计学意义(P>0.05),研究组病程≥10d、是否应用氨氯地平及血压变异性均高于对照组(P<0.05),病程≥10d与血压变异性高均为危险性因素,而氨氯地平使用则为保护性因素(P<0.05)。血肿及血肿周围水肿体积在各个时间点比较,差异有统计学意义(F=20.362,P=0.000),另外轮廓分析显示,血肿的体积变化率及血肿周围水肿体积的变化率总体轮廓相互平行(F=10.751,P=0.000)。结论临床中高血压脑出血患者的颅内血肿周围水肿体积扩大受诸多因素影响,如病程、血压变异性等,及时采取措施进行治疗,以期能缩短康复进程,同时加强对高血压管理,合理应用药物,降低高血压变异性,预防及控制血肿周围水肿的体积扩大。

Objective To investigate factors that affect intracranial hematoma and the increased perihematomal edema(PHE)volume in patients with hypertensive cerebral hemorrhage(HCH).Methods Seventy-six HCH patients admitted to our hospital from January 2018 to January 2019 were divided into two groups according to the degree of PHE,including the control group(patients with non-increased PHE volume,n=38)and the study group(patients with increased PHE volume,n=38).Clinical information and influencing factors were compared between the two groups.Results There were no significant differences in age and gender between the two groups(P>0.05).The study group showed more cases featuring the course of disease≥10 days,the use of amlodipine and blood pressure variability than the control group(P<0.05).The course of disease≥10 days and blood pressure variability were risk factors,and the use of amlodipine was a protective factor(P<0.05).There were statistically significant differences in hematoma and the PHE volume between multiple time points(F=20.362,P=0.000).In addition,craniocerebral imaging showed that the rates of changes in the hematoma volume and PHE volume were generally parallel to the outline of the skull(F=10.751,P=0.000).Conclusion Multiple factors such as the course of disease and blood pressure variability can affect intracranial hematoma and the increased PHE volume in HCH patients in clinical practices.Timely therapies should be conducted for shortening recovery time.Along with strengthening hypertension management and lowering blood pressure variability with proper drug use,intracranial hematoma and increased PHE volumes can be prevented and controlled.