急性脑出血患者发生早期神经功能恶化的相关因素及对预后的影响

Correlative Factors of Early Neurological Deterioration in Patients with Acute Cerebral Hemorrhage and Their Influence on Prognosis

目的:探讨急性脑出血患者发生早期神经功能恶化的相关因素对预后的影响。方法:以2018年1月-2020年1月笔者所在医院收治的87例急性脑出血患者为研究对象,依据患者病程早期神经功能变化情况分为恶化与非恶化两组,回顾性分析两组临床资料,Logistic回归分析患者早期神经功能恶化的危险因素,比较观察两组预后情况。结果:87例急性脑出血患者中,早期神经功能恶化(END)患者29例,非END患者58例。END组入院GCS评分低于非END组,NIHSS评分、FBG、NE、Hcy水平均高于非END组,平均血肿体积大于非END组,出血破入脑室与血肿体积增大占比均高于非END组,差异均有统计学意义(P<0.05)。Logistic回归分析示入院GCS评分低、FBG高、Hcy高、血肿体积大是急性脑出血患者发生END的独立危险因素,差异均有统计学意义(P<0.05)。恶化患者预后不良率高于非恶化患者,差异有统计学意义(P<0.05)。结论:急性脑出血患者发生早期神经功能恶化的危险因素较多,此类患者预后更差,应引起临床重视,尽早发现高危人群并予以有效干预,以促进预后改善。

Objective:To analyzed correlative factors of early neurological deterioration in patients with acute cerebral hemorrhage and their influence on prognosis.Method:A total of 87 patients with acute cerebral hemorrhage admitted to our hospital from January 2018 to January 2020 were selected as the research subjects,and the patients were divided into two groups according to the changes of neurological function in the early stage of the disease course.The clinical data of the two groups were retrospectively analyzed.Logistic regression analysis of the risk factors of early neurological deterioration in patients,comparison and observation of the prognosis of the two groups.Result:Among the 87 patients with acute intracerebral hemorrhage,29 were END patients and 58 were non-END patients.The GCS score in the END group was lower than that in the non-END group,NIHSS score,FBG,NE and Hcy levels were higher than those in the non-END group,the average hematoma volume was higher than that in the non-END group,and the proportion of hemorrhage into the ventricle and hematoma volume enlargement were higher than those in the non-END group,the differences were statistically significant(P<0.05).Logistic regression analysis showed that low GCS score,high FBG,high Hcy and large hematoma volume were independent risk factors for the occurrence of END in patients with acute cerebral hemorrhage,the differences were statistically significant(P<0.05).The poor prognosis rate of deteriorating patients was higher than that of non-deteriorating patients,the difference was statistically significant(P<0.05).Conclusion:There are many risk factors for the deterioration of early neurological function in patients with acute cerebral hemorrhage,and the prognosis of such patients is worse.Clinical attention should be paid to high-risk groups as soon as possible and effective intervention to promote the improvement of prognosis.