摘要
目的探讨高血压性脑出血颅内血肿清除术后并发癫痫发作的影响因素。方法回顾性分析2011年3月至2018年7月开颅血肿清除术治疗的485例高血压性脑出血的临床资料。采用多因素logistic回归分析检验术后并发癫痫的危险因素。结果485例中,术后发生癫痫62例(12.9%)。多因素logistic回归分析结果显示,血肿体积≥60ml、血肿位于小脑、术后再出血、术后电解质紊乱、脑电图异常、术前C反应蛋白(CRP)水平升高、术前肿瘤坏死因子-α(TNF-α)水平升高、术前白细胞介素-6(IL-6)水平升高是术后并发癫痫发作的独立危险因素(P<0.05)。结论高血压性脑出血开颅血肿清除术后癫痫发作发生率较高,对于血肿较大、血肿位于小脑、术后再出血、术后电解质紊乱、脑电图异常、术前CRP、TNF-α、IL-6水平升高的病人,应采取针对性措施预防术后癫痫发作。
Objective To investigate the factors related to the postoprative epileptic seizures in the patients with hypertensive intracerebral hemorrhage(HICH).Methods The clinical data of 485 patients with HICH treated by evacuation of intracerebral hematomas in our hospital from March,2011 to July,2018 were analyzed retrospectively.Of these 485 patients,62 had epileptic seizures and 423 not.The factors related to the postoperative epileptic seizures were statistically analyzed.Results The univariate analysis showed that the factors related to the postoperative epileptic seizures included the patient's age,volume and location of intracerebral hematomas,postoperative rebleeding,electrolyte level,preoperative levels of serum C-reactive protein(CRP),tumor necrosis(TNF-a)and interleukin-6(IL-6)and hydrocephalous(P<0.05).The multivariate logistic regression analysis showed that the independent risk factors related to the postoperative epileptic seizures included the large volume of hematoma,hematoma located in the cerebellum,postoperative rebleeding,electrolyte disturbance,higher levels of preoperative serum CRP,TNF-αand IL-6(P<0.05).Conclusion It is suggested the incidence of postoperative epileptic seizures is very high after the surgery in the HICH patients undergoing craniotomy who have cerebellar hematomas,hematoma volume>45 ml,disturbance of electrolyte level,higher levels of preoperative serum CRP,TNF-a and IL-6 and postoperative cerebral rebleeding.
作者
谢明德
金法
冯荣亮
XIE Ming-de;JIN Fa;FENG Rong-liang(Department of Neurosurgery,Deqing County People's Hospital,Zhaoqing 526600,China;Department of Neurosurgery,Pearl River Hospital,Southern Medical University,Guangzhou 510000,China;Department ofNeurosurgery,Zhaoqing Municipal First People's Hospital,Zhaoqing 526000,China)
出处
《中国临床神经外科杂志》
2019年第10期605-607,共3页
Chinese Journal of Clinical Neurosurgery
关键词
高血压性脑出血
开颅血肿清除术
癫痫
危险因素
Hypertensive intracerebral hemorrhage
Craniotomy hematoma removal
Epileptic
Risk factors
