高血压伴基底节区脑出血患者的预后相关因素分析

Prognostic correlation factors for hypertensive intracerebral hemorrhage in the basal ganglia and thalamus

目的 分析高血压基底节区脑出血患者的治疗效果,并探讨预后相关因素,为临床治疗提供参考依据。方法 回顾性分析2017年1月至2019年12月神经外科收治650例丘脑基底节区脑出血患者的临床资料,统计患者的年龄、入院格拉斯哥昏迷指数(GCS)评分、血肿量、血肿部位、脑室积血、中线移位、血压、治疗方式以及出院后3个月日常生活活动能力量表(ADL)评分等指标,并采用Logistic多元回归分析影响预后的相关因素。结果 入院GCS评分、血肿量、血肿部位、中线移位和血压波动程度均与预后相关[OR(95%CI)=3.511(1.680~8.245)、4.524(2.017~9.781)、3.194(1.004~7.935)、4.524(2.042~9.817)、5.024(2.317~9.881),均P <0.05]。结论 临床上应及时检测和了解患者相关危险因素,特别是入院GCS评分、血肿量、血肿部位和血压波动,为挽救患者生命及改善预后提供客观临床依据。

Objective To analyze the therapeutic effect of hypertensive basal ganglia and thalamus hemorrhage, and explore the prognostic factors to provide reference for clinical treatment. Methods The clinical data of 650 patients with basal gangliaand thalamus hemorrhage from January 2017 to December 2019 were retrospectively analyzed.The patient’s age, admission Glasgow Coma Index(GCS) score, hematoma volume, hematoma site, cerebral ventricular effusion, median displacement, blood pressure, treatment method, and activities of daily living(ADL) score of 3 months after discharge were collected. Logistic multiple regression analysis was used to analyze the prognostic factors. Results The admission GCS score, hematoma volume, hematoma site, midline shift and blood pressure fluctuation were all related to prognosis[OR(95%CI)=3.511(1.680-8.245), 4.524(2.017-9.781), 3.194(1.004-7.935), 4.524(2.042-9.817), 5.024(2.317-9.881);all P < 0.05]. Conclusion It is necessary to detect and understand the risk factors in time, especially the admission GCS score, hematoma volume, hematoma location and blood pressure fluctuation, so as to provide objective clinical basis for saving the patient’s life and improving the prognosis.