黄兴华

【摘要】 目的：分析自发性脑出血急性期血肿扩大相关危险因素。方法：选取2016年3月22日-2017年3月22日自发性脑出血患者50例作为研究对象，对所有患者进行CT检查，回顾性分析临床资料，根据血肿性质分为两组，血肿扩大者20例为观察组，血肿未扩大者30例为对照组。结果：观察组患者不均质血肿占75.00%、不规则血肿占85.00%、血肿量（33.74±5.42）ml、入院3 h时SBP（175.48±12.36）mm Hg、入院时SBP（167.85±15.84）mm Hg、抽烟史占55.00%、抗凝治疗史占40.00%、脑卒中史占30.00%、糖尿病占90.00%、高血压病占75.00%、GCS（8.12±1.69）分、年龄（64.12±5.86）岁均高于对照组，比较差异均有统计学意义（P<0.05）；进行Logistic多因素分析后，发现不规则血肿率、疾病史、GCS、入院3 h时SBP、不均质血肿、血肿量、年龄为自发性脑出血患者独立危险因素。结论：导致自发性脑出血患者引起血肿扩大的独立危险因素为疾病史、血肿量、入院3 h时SBP、GCS。

【关键词】 自发性脑出血； 血肿扩大； 危险因素

doi：10.14033/j.cnki.cfmr.2018.7.010 文献标识码 B 文章编号 1674-6805（2018）07-0023-03

【Abstract】 Objective：To analyze the risk factors of hematoma enlargement in spontaneous cerebral hemorrhage.Method：From March 22th 2016 to March 22th 2017，50 patients with spontaneous cerebral hemorrhage were selected.All patients underwent CT examination.The clinical data were analyzed retrospectively.According to the hematoma properties，the patients were divided into two groups.Hematoma enlargement in 20 cases was the observation group，and hematoma did not expand in 30 cases as control group.Result：In the observation group，heterogeneous hematoma accounted for 75.00%，irregular hematoma accounted for 85.00%，hematoma volume was（33.74±5.42）ml，SBP at 3 hours after admission was （175.48±12.36）mm Hg，SBP at admission was （167.85±15.84）mm Hg，smoking history accounted for 55.00%，anticoagulant history accounted for 40.00%，history of stroke accounted for 30.00%，diabetes accounted for 90.00%，hypertension accounted for 75.00%，GCS was （8.12±1.69）points，age （64.12±5.86）years old were higher than those in the control group，the differences were statistically significant（P<0.05）.Logistic multi-factor analysis showed that the incidence of irregular hematoma， history of disease，GCS，SBP at 3 hours after admission，heterogeneous hematoma，hematoma volume and age were independent risk factors for patients with spontaneous cerebral hemorrhage.Conclusion：The independent risk factors of spontaneous cerebral hemorrhage causing hematoma enlargement were history of disease，amount of hematoma，SBP at 3 hours after admission and GCS.

【Key words】 Spontaneous cerebral hemorrhage； Hematoma enlargement； Risk factors

First-authors address：No.5 Peoples Hospital of Nanhai District，Foshan 528231，China

自發性脑出血具有致残率高、死亡率高、预后差、发病率高等特点，可因各种原因引起脑血管自发性破裂，从而并发出血，当出血不止、且呈血肿扩大趋势，代表病情已处于危急化[1]。目前常使用CT扫描，且具有无创性、操作迅速、结果可靠等优势，能够促使医务人员对患者病情起到动态性观察，且能够了解血肿密度和血肿形态，利于治疗方案的拟定[2]。本文旨在探索自发性脑出血急性期血肿扩大相关危险因素，具体可见下文描述。

1 资料与方法

1.1 一般资料

本次研究对象为自发性脑出血患者，共50例，均在2016年3月22日-2017年3月22日收治，男25例，女25例，年龄51～78岁，平均（65.85±3.66）岁，病程10～30 d，平均（16.38±3.51）d，回顾性分析临床资料，根据患者血肿性质分为两组，血肿扩大者20例为观察组，血肿未扩大者30例为对照组。入选标准：（1）患者均在发病后3 h进行CT检查，明确为自发性脑出血；（2）患者均存在自发性脑出血的临床诊断标准；……