| 刘悦沈正奎李颖慧张林山毛远红王丽琨.立体定向微创技术治疗脑出血再出血风险的
预测指标分析[J].神经损伤功能重建,2019,14(6):281-284 |
| 立体定向微创技术治疗脑出血再出血风险的
预测指标分析 |
| Factors for Predicting Postoperative Rebleeding after Minimally Invasive Stereotactic Surgeryfor Intracerebral Hemorrhage |
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| DOI： |
| 中文关键词: 脑出血 再出血 Logistic模型 头颅CT值 血肿形态 |
| 英文关键词: intracerebral hemorrhage rebleeding Logistic model CT value hematoma shape |
| 基金项目:贵州省科技厅基金
（No. 黔科合LH 字
[2017]7187 号） |
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| 中文摘要: |
| 目的：分析立体定向微创技术治疗脑出血再出血风险的预测指标。方法: 纳入发病72 h 内入院并行
立体定向微创手术治疗的脑出血患者295 例，根据有无术后再出血分为再出血组68 例及非再出血组227 例；
以有无再出血为因变量，以入院头颅CT值、血肿形态不规则、高血压病史为自变量进行二元Logistic 回归分
析，评估入院时CT平扫血肿形态及高血压病史与术后再出血之间的关系。结果：再出血组血肿形态不规则
47 例（69.1%），而非再出血组血肿不规则者仅69 例（30.39%）。再出血组出院时神经功能评分明显高于非再
出血组，拔管时残余血肿量也高于非再出血组。二元Logistic 回归分析显示入院CT血肿形态不规则、入院
CT值和高血压病史是术后再出血的独立预测因子。结论：入院CT值、血肿边界不规则、高血压病史是微创
技术治疗脑出血后再出血的预测因素。 |
| 英文摘要: |
| To analyze the factors for predicting postoperative rebleeding in patients with
intracerebral hemorrhage (ICH) after minimally invasive stereotactic surgery. Methods: A total of 295 ICH
patients who underwent minimally invasive stereotactic surgery within 72 hours of symptom onset were included
in the present study. Patients were divided into the rebleeding group (n=68) and non-rebleeding group (n=227)
according to the presence or absence of postoperative rebleeding. With rebleeding and non-rebleeding as
dependent variables and initial cranial CT values upon hospitalization, irregular hematoma, and history of
hypertension as independent variables, we used binary Logistic regression to assess the relationship between the
presence of postoperative rebleeding and the shape of initial hematoma and hypertension history. Results: There
were 47 patients (69.1%) with irregular hematoma in the rebleeding group while only 69 patients (30.39%) in the
non-rebleeding group. The NIHSS score at discharge of the rebleeding group was significantly higher than that of
the non-rebleeding group. Upon extubation, the rebleeding group displayed greater residual hematoma volume
than the non-rebleeding group. Binary Logistic regression showed that irregular hematoma, initial CT values, and
hypertension history were independent predictors of postoperative rebleeding. Conclusion: CT value at
hospitalization, irregular hematoma, and history of hypertension are predictive factors for postoperative
rebleeding in patients who underwent minimally invasive stereotactic surgery for the treatment of ICH. |
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