摘要
目的 了解中国自发性脑出血继发脑室出血人群预后相关的影响因素。方法 检索PubMed、Embase、Cochrane Library、万方、中国知网、维普数据库中有关自发性脑出血继发脑室出血病例预后分析的队列研究,检索时限为从1990年1月1日—2023年6月18日,最终共纳入11项非随机病例对照研究,共计944例自发性脑出血继发脑室出血患者,包括583例预后良好和361例预后不良的患者。采用Newcastle-Ottawa量表评估质量,RevMan 5.4.0软件进行Meta分析。结果 患者发病时意识障碍(OR=7.38,95%CI=4.91~11.09,P<0.00001)、年龄(OR=2.66,95%CI=1.57~4.51,P=0.0003)、出血量(OR=8.45,95%CI=4.95~14.41,P<0.00001)、出血部位(OR=10.18,95%CI=3.43~30.20,P<0.0001)、入院血糖(OR=5.76,95%CI=2.87~11.54,P<0.00001)、中线有无移位(OR=4.67,95%CI=2.50~8.72,P<0.00001)、破入脑室的部位(OR=3.80,95%CI=2.38~6.08,P<0.00001)、范围(OR=0.18,95%CI=0.08~0.40,P<0.0001)和程度(OR=9.34,95%CI=5.10~17.13,P<0.00001)、瞳孔改变(OR=191.67,95%CI=36.44~1008.04,P<0.00001)、脑膜刺激征(OR=9.76,95%CI=4.09~23.25,P<0.00001)、治疗方案(OR=0.31,95%CI=0.15~0.64,P=0.02)、脑室铸型(OR=8.01,95%CI=3.09~20.76,P<0.0001)是继发脑室出血患者预后不良的危险因素。结论 发病时意识障碍、年龄>70岁、出血量≥20 ml、脑干出血、入院时血糖值高、中线有移位、3、4脑室受累、破入脑室范围广、双瞳孔不等大、有脑膜刺激征、脑室铸型、采用内科治疗方案是发生SIVH预后不良的危险因素,能够为SIVH预防决策的制定提供循证依据。
Objective To investigate the factors influencing the prognosis of of patients with secondary ventricular hemorrhage due to spontaneous cerebral hemorrhage in China.Methods Cohort studies on prognosis analysis of secondary ventricular hemorrhage of spontaneous intracerebral hemorrhage were searched from PubMed,Embase,Cochrane Library,Wanfang,CNKI and VIP databases,the studies published from January 1st 1990 to June 16th 2023.A total of 11 non-randomized case-control studies involving 944 patients with intraventricular hemorrhage secondary to spontaneous intracerebral hemorrhage were included,including 583 patients with good prognosis and 361 patients with poor prognosis.Newcastle-Ottawa scale was used to assess quality,and meta-analysis was carried out by using RevMan 5.4.0 software.Results Disorder of consciousness at onset(OR=7.38,95%CI=4.91~11.09,P<0.00001),age(OR=2.66,95%CI=1.57~4.51,P=0.0003),amount of blood loss(OR=8.45,95%CI=4.95~14.41,P<0.00001),bleeding site(OR=10.18,95%CI=3.43~30.20,P<0.0001),blood glucose on admission(OR=5.76,95%CI=2.87~11.54,P<0.00001),midline displacement(OR=4.67,95%CI=2.50~8.72,P<0.00001),location of ventricle penetration(OR=3.80,95%CI=2.38~6.08,P<0.00001),range(OR=0.18,95%CI=0.08~0.40,P<0.0001)and degree(OR=9.34,95%CI=5.10~17.13,P<0.00001),pupil change(OR=191.67,95%CI=36.44~1008.04,P<0.00001),meningeal stimulation sign(OR=9.76,95%CI=4.09~23.25,P<0.00001),treatment plan(OR=0.31,95%CI=0.15~0.64,P=0.02)and ventricular casting(OR=8.01,95%CI=3.09~20.76,P<0.0001)were risk factors for poor prognosis in patients with secondary ventricular hemorrhage.Conclusions Disturbance of consciousness,age over 70 years old,bleeding volume over or equal to 20mL,brainstem hemorrhage,high blood glucose value on admission,midline shift,involvement of the third and fourth ventricle,wide range of ventricular break,the pupils were unequal,meningeal irritation sign,ventricular cast,and internal medical treatment are risk factors for poor prognosis of SIVH,which can provide an evidence-based basis for the preve
作者
朱清清
张沁丽
韩秀燕
许华
Zhu Qingqing;Zhang Qinli;Han Xiuyan;Xu Hua(Department of Neurology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi,Shanxi 046000,China)
出处
《齐齐哈尔医学院学报》
2024年第9期877-885,共9页
Journal of Qiqihar Medical University
关键词
自发性脑出血继发脑室出血
预后
危险因素
META分析
Spontaneous cerebral hemorrhage secondary ventricular hemorrhage
Prognosis
Risk factors
Meta-analysis
