影响手术治疗基底节高血压脑出血近期预后的相关因素

Related factors affecting the short-term prognosis of surgical treatment of basal ganglia hypertensive cerebral hemorrhage

目的探讨影响手术治疗基底节高血压脑出血近期预后的相关因素。方法选择2019年1—12月在我院诊断治疗的基底节高血压脑出血患者83例为研究对象。所有患者均经手术治疗,随访1个月;采用改良Rankin量表对患者近期术后情况进行评价,≤2分为预后良好,≥3分为预后不良;对影响患者近期预后不良的相关因素进行单因素及多因素分析。结果随访1个月,83例患者中,62例患者得分≥3分,为预后不良,占74.70%;21例患者得分≤2分,为预后良好,占25.30%。单因素分析结果显示,入院时血压≥180 mmHg、入院时NIHSS≥15分、GCS≥8分、破入脑室、上消化道出血、出血量大、抗生素应用时间长、再出血、术后肺部感染、术中出血量大、残余血肿大的患者,预后不良率更高,差异有统计学意义(P<0.05)。多因素分析结果显示,NIHSS评分、GCS评分、SBP、抗生素应用时间、术后肺部感染、再出血是影响手术治疗基底节高血压脑出血近期预后的相关因素(P<0.05)。结论患者入院时的神经功能缺损情况、收缩压水平、术后再出血发生率、抗生素应用时间等是影响基底节高血压脑出血患者近期预后的相关因素。

Objective To explore the related factors affecting the short-term prognosis of surgical treatment of basal ganglia hypertensive cerebral hemorrhage.Methods Eighty-three patients with basal ganglia hypertensive cerebral hemorrhage diagnosed and treated in our hospital from January to December 2019 were selected as the research subjects.All patients were treated with surgery and followed up for one month.The modified Rankin scale was used to evaluate the patients′recent postoperative conditions,≤2 points indicating good prognosis and≥3 points indicating bad prognosis.Univariate and multivariate analysis was used to analyze the related factors influencing patients′poor prognosis in the near future.Results During a month of follow-up,62 of 83 patients with scores≥3 were classified as poor prognosis,accounting for 74.70%,and 21 patients with scores≤2 were classified as good prognosis,accounting for 25.30%.Univariate analysis showed that patients with blood pressure≥180 mmHg and NIHSS≥15 at admission,GCS≥8,rupturing into the cerebral ventricle,upper gastrointestinal bleeding,large amount of bleeding,long antibiotic application time,rebleeding,postoperative lung infections,large intraoperative blood loss,and large residual hematoma had higher poor prognosis rate,and the difference was statistically significant(P<0.05).The multivariate analysis showed that NIHSS score,GCS score and SBP,antibiotic application time,postoperative lung infection,and rebleeding were the relevant factors affecting the short-term prognosis of surgical treatment of basal ganglia hypertensive cerebral hemorrhage(P<0.05).Conclusion The neurological deficit,systolic blood pressure at admission,incidence of postoperative rebleeding,and time of antibiotic application are related factors affecting the short-term prognosis of patients with basal ganglia hypertensive cerebral hemorrhage.