儿童脑出血患者住院期间脑积水危险因素研究

Risk Factors for Hydrocephalus in Children with Intracerebral Hemorrhage

目的探讨儿童脑出血患者发生脑积水的相关危险因素,为早期识别儿童脑出血患者发生脑积水的风险提供循证依据。方法本研究为多中心回顾性分析,纳入北京市4家医院2018年度诊治的脑出血或非创伤颅内出血的儿童患者资料。从病案资料中收集患儿年龄、性别、医疗保险类型、影像检查结果、住院期间并发症(脑积水、癫痫和肺部感染)、住院时长和住院总费用等信息。通过多因素logistic回归分析,探讨儿童脑出血患者住院期间发生脑积水的危险因素。结果研究共纳入140例脑出血儿童患者,其中17例(12.14%)发生脑积水。与未发生脑积水患者相比,脑积水患者脑室内出血比例更高(64.71%vs 20.33%,P<0.01),住院发生肺部感染的比例也更高(41.18%vs 4.88%,P<0.01)。多因素logistic回归模型分析显示,低龄(OR 1.15,95%CI 1.01~1.31,P=0.03)、脑室出血(OR 9.77,95%CI 2.99~31.87,P<0.01)是儿童脑出血患者住院期间发生脑积水的独立危险因素。结论低龄、脑室出血可能为儿童脑出血发生脑积水的独立危险因素。

Objective To investigate the risk factors of hydrocephalus in children with cerebral hemorrhage,and to provide evidence for early identification of the children at high risk of hydrocephalus.Methods This retrospective study enrolled the data of hospitalized children with intracerebral hemorrhage or nontraumatic intracranial hemorrhage from 4 hospitals in Beijing in 2018.The baseline information were collected,including demographics,type of medical insurance,imaging results,complications during hospitalization,length of stay and total cost of hospitalization.Multivariate logistic regression analysis was used to analyze the risk factors of cerebral hemorrhage combined with hydrocephalus in children.Results A total of 140 children with intracerebral hemorrhage were included in the study,of which 17 cases(12.14%)had hydrocephalus during hospitalization.The patients with hydrocephalus had higher incidence of intraventricular hemorrhage(64.71%vs 20.33%,P<0.01)and pulmonary infection during hospitalization(41.18%vs 4.88%,P<0.01),compared with patients without hydrocephalus.Multivariate logistic regression analysis showed that younger age(OR 1.15,95%CI 1.01-1.31,P=0.03)and intraventricular hemorrhage(OR 9.77,95%CI 2.99-31.87,P<0.01)were independent risk factors for hydrocephalus in hospitalized children with cerebral hemorrhage.Conclusions Younger age and intraventricular hemorrhage may be independent risk factors for hydrocephalus in children with cerebral hemorrhage.