影响微创术治疗重型高血压脑出血患者预后因素及死亡原因分析

Prognostic Factors and Causes of Death in Patients with Severe Hypertensive Intracranial Hematoma after Microinvasive Drainage

目的:探讨影响微创术治疗重型高血压脑出血患者预后因素及死亡原因,以进一步提高疗效。方法:收集微创治疗重型高血压脑出血患者49例,将死亡病例与治疗好转病例的临床资料进行比较,并分析死亡原因。结果:死亡组与好转组比较,来诊时昏迷程度深者、发病后呕吐者、合并基础疾病者、再出血及高渗状态者均有显著性差异(P均<0.01)。死亡原因主要有:肺部感染,中枢性衰竭,MOF,再出血,心、肾功能衰竭,颅内感染。结论:影响微创术治疗重型高血压脑出血患者预后的因素主要有来诊时昏迷程度深、发病后呕吐、合并基础疾病、再出血及高渗状态。治疗应针对各危险因素,积极防治肺部感染、再出血、高渗状态及MODS等。

Objective: To analyze the prognostic factors, the causes of death in patients with severe hypertensive intracranial hematoma after microinvasive drainage. Methods: 49 patients with severe hypertensive intracranial, hematoma after microinvasive drainage were enrolled and divided into the dead and the survival groups and analyzed the causes of death. Results: The risk factors were as follows: deep coma, vomiting after onset, underlying diseases, rehemorrhage and hyperosmotic of serum. Comparing two groups, the factors were found to be statistically different (all p<0.01). The major causes of death included pulmonary infection, central failure, MOF, rehemorrhage, heart or renal failure and intracranial infection. Conclusion: The evaluated risk factors for prognosis should be associated with the following variables: deep coma, vomiting after onset, underlying diseases, rehemorrhage and hyperosmotic of serum. The strategy of treatment should be aimed at blocking of those risk factors.