[1]夏捷生,冯建飞,李巧玲,等.自发性脑出血破入脑室与否的预后比较分析[J].临床神经外科杂志,2019,16(5):369-375.[doi:10.3969/j.issn.1672-7770.2019.05.001]
 XIA Jie-sheng,FENG Jian-fei,LI Qiao-ling,et al.Prognostic comparison and analysis of spontaneous intracerebral hemorrhage with or without ventricular extension[J].Journal of Clinical Neurosurgery,2019,16(5):369-375.[doi:10.3969/j.issn.1672-7770.2019.05.001]
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自发性脑出血破入脑室与否的预后比较分析()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第5期
页码:
369-375
栏目:
脑血管病专题
出版日期:
2019-10-15

文章信息/Info

Title:
Prognostic comparison and analysis of spontaneous intracerebral hemorrhage with or without ventricular extension
作者:
夏捷生冯建飞李巧玲张超胡荣冯华
400038 重庆,陆军军医大学第一附属医院(重庆西南医院)神经外科
Author(s):
XIA Jie-sheng FENG Jian-fei LI Qiao-ling et al.
Department of Neurosurgery, The First Hospital Affiliated To AMU(Southwest Hospital), Chongqing 400038, China
关键词:
自发性脑出血破入脑室预后
Keywords:
spontaneous intracerebral hemorrhage ventricular extension prognosis
分类号:
R651.1
DOI:
10.3969/j.issn.1672-7770.2019.05.001
文献标志码:
A
摘要:
【摘要】目的探讨自发性脑出血破入脑室与否对患者预后的影响及其相关危险因素。方法回顾性分析陆军军医大学第一附属医院2010年1月—2016年12月收治的1 342例sICH患者的临床资料。根据出血是否破入脑室分为破入脑室组(455例,33.9%)与未破入脑室组(887例,66.1%),比较分析两组患者预后的差异及其影响因素。结果破入脑室组的平均住院时间为(25.1±26.7)d、出院时mRS评分4(3,5)分、死亡率14.1%,未破入脑室组分别为(20.9±21.8)d、3(2,4)分及2.5%,两组的差异均有统计学意义(均P<0.05)。单因素Logistic回归分析结果显示,破入脑室(OR=2.521,P=0.000)为sICH患者预后不良的独立危险因素。对未破入脑室组与破入脑室组预后相关影响因素分别进行多因素Logistic回归分析显示,病程>24 h(OR=0.566,P=0.001 vs OR=0.547,P=0.032)均为两组保护因素;入院格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分≤8分(OR=5.146,P=0.004 vs OR=11.013,P=0.000)、血肿形态不规则(OR=2.053,P=0.000 vs OR=3.648,P=0.000)、肺部感染(OR=2.356,P=0.000 vs OR=1.994,P=0.012)均为危险因素。对患者年龄、性别、血肿量、血肿部位、血肿形态、密度、入院GCS评分作森林图亚组分析,仅血肿部位亚组差异有统计学意义(P<0.05)。结论自发性脑出血破入脑室患者预后总体差于未破入脑室者,破入脑室是影响自发性脑出血患者预后的独立危险因素。不同出血部位破入脑室与未破入脑室患者的预后有明显不同;病程>24 h为破入脑室和未破入脑室预后的保护因素,而入院GCS评分≤8分、肺部感染、血肿形态不规则为预后不良的危险因素。
Abstract:
Abstract: ObjectiveTo compare and analyze the influence of spontaneous intracerebral hemorrhage(sICH) on the prognosis of patients with or without ventricular extension. MethodsThe clinical data of 1 342 patients with sICH from 2010 to 2016 in The First Hospital Affiliated To AMU, who were divided into two groups according to whether it drainaged into ventricles, were analyzed retrospectively. ResultsOf 1 342 patients, 455 (33.9%) were with ventricular extension and 887(66.1%) without. Statistically significant difference was found in group with ventricular extension whose average length of stay(25.1±26.7) d, mRS score at discharge [4 (3,5) points], mortality(14.1%), and group without ventricular extension whose average length of stay(20.9±21.8) d, mRS score at discharge [3 (2,4) points], mortality(2.5%)(P<0.05). Univariate logistic regression analysis showed that drainaged into ventricles(OR=2.521,P=0.000) was an independent risk factor for poor prognosis of patients with sICH. Multivariate logistic regression analysis of the group without ventricular extension and the group with ventricular extension showed that, the course of disease >24 h(OR=0.566,P=0.001 vs OR=0.547,P=0.032) were protective factors in both groups, admission GCS≤8 scores(OR=5.146,P=0.004 vs OR=11.013,P=0.000), irregular hematoma shape(OR=2.053,P=0.000 vs OR=3.648,P=0.000), pulmonary infection(OR=2.356,P=0.000 vs OR=1.994,P=0.012) were both risk factors. The age, gender, hematoma volume, location, shape, density and admission GCS score of patients were analyzed by forest map subgroup, statistical difference was found only in subgroup of hematoma location(P<0.05). ConclusionsThe prognosis of patients with sICH with ventricular extension is generally worse than that without ventricular extension. Ventricular extension is an independent risk factor of the prognosis of patients with sICH. The prognosis of patients with different hematoma location is significantly different in two groups. The course of disease>24 h is the prognostic protective factor in two groups, while admission GCS≤8 scores, pulmonary infection and irregular hematoma shape are the prognostic risk factors in both groups.

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[2]孔杰,戎金花,颜骏,等.影响青年人自发性脑出血预后的相关因素分析[J].临床神经外科杂志,2016,(03):231.
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更新日期/Last Update: 2019-10-15