高血压脑出血术后患者再出血的相关影响因素分析

Analysis of related influencing factors for rehemorrhage in patients after hypertensive intracerebral hemorrhage surgery

目的探究高血压脑出血术后患者再出血的影响因素。方法回顾性分析2018年8月至2021年8月枣庄市峄城区人民医院收治的90例高血压术后患者的临床资料。采用单因素及非条件Logistic多因素回归分析影响高血压脑出血术后患者再出血的危险因素。结果术后再出血患者与术后未出血患者入院收缩压、入院舒张压、入院格斯拉昏迷(GCS)评分、入院时出血量、出血部位、是否凝血功能异常、接受治疗时的发病时间、手术方式和是否术后血压波动大比较差异有统计学意义(P<0.05);术后再出血患者与术后未出血患者年龄、性别、病程、术前脑疝、是否监测颅内压、是否彻底清除血肿和是否合并糖尿病比较差异无统计学意义。多因素Logistic回归分析结果显示,入院收缩压较高、入院舒张压较高、入院时出血量较多、凝血功能异常、骨瓣开颅血肿清除术和术后血压波动大为影响高血压脑出血患者术后再出血结局的危险因素(P<0.05)。结论入院时收缩压和舒张压较高、入院时出血量较多、凝血功能异常、接受骨瓣开颅血肿清除术和术后血压波动大为导致脑出血患者术后再出血的独立危险因素,临床治疗时应对此类患者予以重视。

Objective To explore the influencing factors for re-hemorrhage in patients with hypertensive intracerebral hemorrhage after surgery.Methods The clinical data of 90 patients after hypertension surgery admitted to Yicheng District People's Hospital of Zaozhuang City from August 2018 to August 2021 were retrospectively analyzed.Univariate analysis and unconditional Logistic multivariate regression analysis were used to ana-lyze the risk factors for re-hemorrhage in patients after hypertensive intracerebral hemorrhage surgery.Results There were statistically significant differences in the aspects of systolic blood pressure at admission,diastolic blood pressure at admission,Glasgow coma scale(GCS)score at admission,blood loss at admission,bleeding site,presence or absence of abnormal coagulation function,onset time at the time of treatment,surgical method and presence or absence of postoperative blood pressure fluctuation between patients with postoperative re-hemorrhage and patients without postoperative re-hemorrhage(P<0.05);there were no significant differences in age,gender,course of disease,preoperative cerebral hernia,presence or absence of intracranial pressure monitoring,presence or absence of complete hematoma removal and presence or absence of diabetes mellitus between patients with postoperative re-hemorrhage and patients without postoperative re-hemorrhage.Multivariate Logistic regression analysis showed that the high systolic blood pressure at admission,high diastolic blood pressure at admission,high blood loss at admission,abnormal coagulation function,hematoma clearance by craniotomy with bone flap and large postoperative blood pressure fluctuation were the risk factors affecting the outcome of postoperative re-hemorrhage in patients with hypertensive intracerebral hemorrhage(P<0.05).Conclusion High systolic blood pressure and diastolic blood pressure at admission,high blood loss at admission,abnormal coagulation function,receiving hematoma clearance by craniotomy with bone flap and large postoperative blood pressure fluctuation are the independent risk factors that can lead to postoperative re-hemorrhage in patients with cerebral hemorrhage,therefore it is necessary to pay attention to such patients in clinical treatment.