摘要
目的观察高血压脑出血(HICH)血肿清除术后患者镇静时间及并发症发生情况,分析持续镇静时间与并发症的关系。方法回顾性分析2016年3月~2019年3月解放军联勤保障部队第904医院(常州院区)经血肿清除术治疗的130例HICH患者,记录患者术后再出血、神经损伤等并发症发生率,将发生并发症的患者纳入发生组(49例),其他未发生的患者纳入未发生组(81例),比较两组患者的基线资料,重点比较术后镇静时间,分析镇静时间与并发症的关系。结果130例患者血肿清除术后发生并发症49例(37.69%),其中再出血25例、神经损伤24例。发生组凝血机制异常、术后发生躁动占比高于未发生组,且发生组镇静时间较未发生组长,差异有统计学意义(P<0.05),组间其他资料比较差异均无统计学意义(P>0.05)。logistic回归分析结果显示,术后躁动、镇静时间过长均是HICH患者血肿清除术后合并并发症可能的因素(OR>1,P<0.05);且以镇静时间带来的影响较显著,可能作为独立因素(OR=12.141);绘制受试者工作特征(ROC)曲线得到镇静时间预测血肿清除术后并发症风险的曲线下面积(AUC)为0.921,取最佳阈值(cut-off值)为25.50 h时,可获得最佳预测价值。结论HICH患者血肿清除术后有较高的合并并发症风险,可能与患者术后躁动、镇静时间等有关,以镇静时间影响较为显著。
Objective To observe the sedation time and complications on patients with hypertensive intracerebral hemorrhage(HICH)after removal of hematona,analyze the relationship between continuous sedation time and post-operative complications.Methods 130 patients with HICH who received hematoma removal for treatment from March 2016 to March 2019 were retrospectively analyzed,recorded the incidence of post-operative rebleeding,nerve injury and other complications;designed a baseline questionnaire recorded and compared the patient’s baseline data in detail;compared the baseline date of patients with and without complications focused on comparing the postoperative sedation time,and analyzed the relationship between sedation time and complications.Results In 130 cases of patients after hematoma removal,49 cases(37.69%)were accompanied with complications,including 25 cases of rebleeding and 24 cases of nerve injury.The incidence of abnormal coagulation mechanism and postoperative restlessness in the occurrence group was higher than that of the non-occurrence group,and the sedation time of the occurrence group was longer than that of the non-occurrence group(P<0.05),compared of other baseline between groups there was no statistical significant different(P>0.05).The results of logistic regression analysis test showed that postoperative restlessness and excessive long sedation time were both possible influencing factors for complications after hematoma removal in HICH patients(OR>1,P<0.05);and the effect brought by sedation time was more significant,which might be used as an independent factor(OR=12.141);the ROC curve was drawn the sedation time predicted the AUC of risk of complications after hematoma removal was 0.921,and the best predictive value can be obtained when the cut-off value was 25.50 h.Conclusion HICH patients have a higher risk of complications after hematoma removal,which may be related to postoperative restlessness and sedation time,while the effect of sedation time is more signifiants.
作者
孟令文
裴荣权
俞凯文
张永明
马亮
汪潇
Meng Lingwen;Pei Rongquan;Yu Kaiwen(Department of Neurosurgery,the 904th Hospital(Changzhou Campus)of the Joint Support Force of the Chinese People’s Liberation Army,Changzhou 213003,China)
出处
《中华保健医学杂志》
2020年第6期627-630,共4页
Chinese Journal of Health Care and Medicine
关键词
高血压脑出血
血肿清除术
镇静时间
并发症
相关性
Hypertensive cerebral hemorrhage
Hematoma removal
Sedation time
Complications
Correlation
