脑出血患者离子水平相关的临床规律及其与外科手术的关系

Clinical regularity of ion level in patients with intracerebral hemorrhage and its relationship with surgery

目的研究脑出血患者离子水平相关的临床规律及其与外科手术的关系并探讨其临床意义。方法搜集并分析219例脑出血患者(手术患者77例和非手术患者142例)入院时及复查、术前及术后的血清K^(+),Na^(+),Ca^(2+),Mg^(2+)及无机磷的数值、入院时血肿体积(根据头部CT影像计算)。结果丘脑-基底节区脑出血术后患者钾钠紊乱发生率明显低于保守治疗患者。经皮尔逊相关性分析,钙离子、镁离子、无机磷浓度与血肿量呈负相关,无机磷组的相关性最强。经多元逐步线性回归分析,血肿量与血清钙、磷呈多元线性相关。结论外科手术治疗丘脑-基底节区脑出血可减轻钾钠离子紊乱,而非丘脑-基底节区脑出血患者的钾钠紊乱不受手术影响。脑出血患者的血肿量越大,血清钙磷镁的浓度越低。

Objective To study the correlation between ion level and surgery in patients with intracerebral hemorrhage and its clinical significance.Methods The serum values of K^(+),Na^(+),Ca^(2+),Mg^(2+),inorganic phosphorus and hematoma volume at admission(computed from head CT images)were collected and analyzed in 219 patients with intracerebral hemorrhage(77 patients with operation and 142 patients without operation)at admission,review,preoperative and postoperative.Results The incidence of serum potassium and sodium disorders in patients with thalamic basal ganglia intracerebral hemorrhage after operation was significantly lower than that in patients with conservative treatment.Pearson correlation analysis showed that the concentrations of calcium ion,magnesium ion and inorganic phosphorus were negatively correlated with the amount of hematoma,and the correlation of inorganic phosphorus group was the strongest.Multiple stepwise linear regression analysis showed that there was a multiple linear correlation between hematoma volume and serum calcium and phosphorus.Conclusion Surgical treatment of thalamic basal ganglia intracerebral hemorrhage can reduce serum potassium and sodium disorders,but the potassium and sodium disorders in patients with non thalamic basal ganglia intracerebral hemorrhage are not affected by surgery.The greater the volume of hematoma in patients with intracerebral hemorrhage,the lower the concentration of serum calcium,phosphorus and magnesium.