神经内镜治疗高血压脑出血术后早期再出血的原因与对策

Causes and Countermeasures of Early Rebleeding after Treatment of Hypertensive Cerebral Hemorrhage with Neuroendoscopy

目的患者通过神经内镜治疗高血压脑出血,对手术后再出血的原因进行分析,制定对策。方法从该院2018年7月—2019年11月间,收治的通过神经内镜治疗的高血压脑出血的患者中随机抽取60例患者,根据是否再次出血进行分组,对引发出血的相关危险因素进行分析,制定有效的对策。结果发现与再次出血相关的危险因素有以下几点:是否实施超早期手术、是否长期饮酒、是否服用了抗血小板药物、术后是否存在血压波动、止血是否确切、入院时的GCS评分,实施超早期手术、长期饮酒、血压存在波动、止血不确切、入院时的GCS评分在11~13分之间发生出血的概率较高,与其他因素相比,差异有统计学意义(χ^2=8.461、6.524、6.493、8.246、10.346,P<0.05)。结论神经内镜治疗高血压脑出血后,引发再次出血的因素较多,但是主要是因为实施了超早期手术、长期饮酒、服用了抗血小板药物、血压存在波动、止血不确切、入院时的GCS评分在11~13分之间,所以,临床中需要对以上情况的患者进行严密观察。

Objective To analyze the causes of postoperative hemorrhage in patients with hypertensive cerebral hemorrhage through neuroendoscopy and develop countermeasures. Methods From July 2018 to November 2019, 60 patients with hypertensive cerebral hemorrhage treated by neuroendoscopy were randomly selected from the hospital.The patients were grouped according to whether they had rebleeding or not, and the risk factor analysis of bleeding, and develop effective countermeasures was related. Results The following risk factors were found to be related to rebleeding: whether ultra-early surgery, long-term drinking, anti-platelet drugs, postoperative blood pressure fluctuations, exact hemostasis, GCS score at admission, implementation Ultra-early surgery, long-term drinking,fluctuations in blood pressure, inaccurate hemostasis, and a high probability of bleeding on admission at a GCS score of11-13 points. Compared with other factors, the difference was statistically significant (χ^2=8.461,6.524,6.493,8.246,10.346,P<0.05). Conclusion There are many factors that cause re-bleeding after neuroendoscopic treatment of hypertensive cerebral hemorrhage, but it is mainly due to the implementation of ultra-early surgery, long-term drinking,anti-platelet drugs, fluctuations in blood pressure, inaccurate hemostasis, the GCS score is between 11-13 points, so patients in the above situation need to be closely observed in the clinic.