摘要
目的探讨高血压脑出血手术治疗近期预后的影响因素。方法回顾经手术治疗的80例高血压脑出血的临床资料,分析性别、年龄、术前GCS评分、术前有无瞳孔异常、出血部位、出血是否破入脑室、脑实质内血肿量、手术时机、术后有无再出血9个因素对预后的影响。日常生活能力(ADL)1～3级为预后良,ADL4～6级为预后差。结果预后良组与预后差组的术前GCS评分、术前有无瞳孔异常、出血部位、脑实质内血肿量、手术时机及术后有无再出血之间有显著性差异(P<0.05),两组的性别、年龄及出血是否破入脑室之间无显著性差异(P>0.05)。仅术前GCS评分和术后有无再出血两个因素被引入Logistic回归方程作为影响预后的有意义因素(χ2=54.820,P<0.001)。术前GCS评分与ADL分级存在负相关(rs=-0.765,P<0.001)。结论术前GCS评分和术后有无再出血是判断高血压脑出血手术治疗近期预后最具参考性的指标,系统了解影响预后的因素有助于规划治疗和估计预后。
Objective To investigate the factors influencing early prognosis of surgical treatment of hypertensive intracerebral hemorrhage (HICH). Methods The clinical data of 80 cases of HICH received surgical treatment were reviewed. Nine prognostic factors were analyzed. They were sex, age, preoperative Glasgow Coma Scale (GCS) score, and preoperative status of pupils, hemorrhage location, secondary intraventricular hemorrhage, volume of intracerebral hematoma, operative timing and postoperative rebleeding. Grade 1-3 of Activities of Daily Living (ADL) was regarded as good prognosis, and grade 4-6 of ADL as poor prognosis. Results There were statistically significant differences between the good prognosis group and the poor prognosis group in the following aspects: preoperative GCS score, preoperative status of pupils, hemorrhage location, volume of intracerebral hematoma, operative timing, and postoperative rebleeding (P < 0.05). The differences between the two groups as for sex, age and secondary intraventricular hemorrhage were statistically insignificant (P > 0.05). Only two factors, preoperative GCS score and postoperative rebleeding, entered the Logistic regression equation as the valid factors influencing prognosis (χ2 = 54.820,P < 0.001. There existed a negative correlation between preoperative GCS scores and ADL grades (rs' = -0.765,P < 0.001). Conclusion Preoperative GCS and postoperative rebleeding are the most valuable indices to the early prognosis of surgical treatment of HICH. Comprehensive understanding of the factors influencing prognosis is helpful for the decision making of treatment and the prediction of prognosis.
出处
《中国微侵袭神经外科杂志》
CAS
2004年第1期14-16,共3页
Chinese Journal of Minimally Invasive Neurosurgery
