高血压脑出血患者血肿清除术后抑郁发生的危险因素

The risk factors of postoperative depression and in hypertensive cerebral hemorrhage patients after hematoma removal

目的探讨高血压性脑出血患者血肿清除术后出现抑郁的危险因素。方法纳入淮南朝阳医院2021年12月~2023年6月85例高血压脑出血患者,血肿清除术后进行抑郁评估,并分为抑郁组以及无抑郁组。单因素分析两组患者性别、年龄、文化程度等病历资料,通过多因素logistics回归分析调查术后抑郁的独立影响因素。结果85例高血压脑出血患者血肿清除术后检出抑郁30例,占比35.29%;抑郁组、非抑郁组在年龄、文化程度、美国国立卫生院卒中量表(The National Institutes of Health Stroke Scale,NIHSS)、血肿位置、出血量、性格类型、失语等因子差异显著(P<0.05),两组性别、婚姻、居住地差异不显著(P>0.05);多因素分析显示,NHISS评分≥15分、额叶血肿、内向型性格、失语、小学文化水平是术后抑郁的独立影响因素。结论高血压脑出血患者血肿清除术后抑郁检出率较高,影响因素包括神经功能缺损程度、血肿位置等,术后应重点关注抑郁高危患者的心理状态。

Objective To investigate the risk factors of postoperative depression and in hypertensive cerebral hemorrhage patients after hematoma removal.Methods Eighty-five patients with hypertensive cerebral hemorrhage in Huainan Chaoyang Hospital from December 2021 to June 2023 were included for depression assessment after hematoma removal and were divided into the depressed group as well as the no-depression group.Univariate analysis was performed to analyze the medical history data of patients in both groups,such as gender,age,and education level.Independent influencing factors of postoperative depression were investigated by multifactorial logistics regression analysis.Results Depression was detected in 30 cases(35.29%)of 85 hypertensive cerebral hemorrhage patients after hematoma removal.There were significant differences between the depressed and non-depressed groups in terms of age,education,the National Institutes of Health Stroke Scale(NIHSS),hematoma location,bleeding volume,personality type,aphasia,and other information(P<0.05).Differences in gender,marriage,and place of residence between the two groups were not significant(P>0.05).Mulifactorial analysis showed that NHISS score≥15,frontal lobe hematoma,introverted personality,aphasia,and elementary school education level were independent influences on postoperative depression.Conclusion The detection rate of depression after hematoma removal in patients with hypertensive cerebral hemorrhage is high,and the influencing factors include the degree of neurological deficit and the location of the hematoma,etc.,and postoperative attention should be focused on the psychological status of patients at high risk of depression.