[1]杨涛,钱中润,鹿松松,等.自发性小脑出血手术治疗长期预后的相关影响因素分析[J].临床神经外科杂志,2020,17(01):66-76.[doi:DOI:10.3969/j.issn.1672-7770.2020.01.015]
 YANG Tao,QIAN Zhong-run,LU Song-song,et al.Analysis on long-term prognosis related factors in surgical management for spontaneous cerebellar hemorrhage[J].Journal of Clinical Neurosurgery,2020,17(01):66-76.[doi:DOI:10.3969/j.issn.1672-7770.2020.01.015]
点击复制

自发性小脑出血手术治疗长期预后的相关影响因素分析()
分享到:

《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
17
期数:
2020年01期
页码:
66-76
栏目:
论著
出版日期:
2020-02-15

文章信息/Info

Title:
Analysis on long-term prognosis related factors in surgical management for spontaneous cerebellar hemorrhage
文章编号:
202001015
作者:
杨涛钱中润鹿松松魏祥品牛朝诗
230001 合肥,中国科学技术大学附属第一医院(安徽省立医院)神经外科
Author(s):
YANG Tao QIAN Zhong-run LU Song-song et al.
Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
关键词:
自发性小脑出血外科手术预后危险因素
Keywords:
spontaneous cerebellar hemorrhage surgical management prognosis risk factors
分类号:
R651.1+2
DOI:
DOI:10.3969/j.issn.1672-7770.2020.01.015
文献标志码:
A
摘要:
目的探讨自发性小脑出血(spontaneous cerebellar hemorrhage,SCH)手术治疗患者长期预后的相关影响因素及其意义。方法对2015年—2018年连续收治的49例SCH手术患者的临床资料进行回顾性分析;分析各临床指标与长期预后的关系。患者平均随访时间28.4个月。预后用格拉斯哥预后量表(Glasgow outcome scale,GOS)评分评定,GOS评分1~3分为预后不良,4~5分为预后良好。结果本组患者的平均年龄为(56.9±17.65)岁,男性占71.4%;预后良好者36例(73.5%),预后不良者13例(26.5%),其中死亡患者9例(18.4%)。单因素分析示:术前GCS评分、入院时随机血糖水平、血肿最大直径、影像学脑干受压(基底池受压)与长期预后有显著关系(P<0.05-0.005)。Logistic回归分析示:入院时随机血糖水平高(OR=1.566,95% CI 1.076~2.279,P=0.019)和影像学脑干受压征(OR=13.533,95% CI 1.058~173.024,P=0.045)为影响长期预后的独立危险因素。结论入院时随机血糖水平高与影像学脑干受压征是影响SCH手术治疗长期预后的独立危险因素。SCH预后相关因素的分析有助于临床医生作出合理的治疗决策。
Abstract:
Objective To explore the long-term prognosis related factors in surgical management for spontaneous cerebellar hemorrhage(SCH). Methods The clinical data of 49 consecutive patients with a first SCH admitted from 2015 to 2018 were analyzed retrospectively. The correlation of clinical features and the prognosis were also analyzed. The average follow-up time was 28.4 months.The prognostic outcomes were assessed according to Glasgow Outcome Scale(COS). GOS scores of 4-5 were defined good outcomes and 1-3 were defined poor outcome. ResultsThe mean age was(56.9±17.65) years and patients were predominantly male(71.4%). The overall clinical outcome according to the GOS at the last follow-up was good(GOS 4-5) in 36 patients(73.5%) and poor(GOS 1-3) in 13 patients(26.5%) in whom 9 (18.4%) died. The results of univariate analysis showed that there were 4 variables related to the prognostic outcomes, including preoperative GCS scores,blood glucose on admission,maximum diameter of hematoma and the radiological brainstem compression(presence of obliterated basal cisterns). Significant factors selected by univariate analysis were further evaluated by logistic regression analysis with forward stepwise selection procedures(P<0.05). Only 2 predictors showed statistical significance in the multivariate analysis, including hyperglycemia(P=0.019,OR=1.566, 95% CI 1.076-2.279) and the radiological brainstem compression(P=0.045,OR=13.533,95% CI 1.058-173.024). ConclusionHyperglycemia and the radiological brainstem compression was the strongest prognostic factor for a poor outcome after SCH onset. The related factors of operative prognosis could be helpful for doctors’ correct decision making for patients with SCH.

相似文献/References:

[1]高登科,姚一,江建东,等.伴发癫痫的优势半球外侧裂脑动静脉畸形手术治疗1例并文献复习[J].临床神经外科杂志,2015,(03):209.
[2]吕彦恩,徐小飞,戴爽,等.外科治疗对癫痫患儿社会能力及行为问题的影响[J].临床神经外科杂志,2016,(03):201.
 LYU Yan-en,XU Xiao-fei,DAI Shuang,et al.Effects of surgery on social mood and behavior outcome in children with epilepsy[J].Journal of Clinical Neurosurgery,2016,(01):201.
[3]宋昭,刘如恩,夏小雨,等.枕下乙状窦后入路手术治疗三叉神经痛的术式选择[J].临床神经外科杂志,2016,(06):459.
 SONG Zhao,LIU Ru-en,XIA Xiao-yu,et al.Option of surgical treatment of trigeminal neuralgia with suboccipital retrosigmoid approach[J].Journal of Clinical Neurosurgery,2016,(01):459.
[4]王强,王汉东,潘灏,等.巨大海绵窦海绵状血管瘤的硬膜内入路显微外科治疗[J].临床神经外科杂志,2020,17(01):42.
 WANG Qiang,WANG Han-dong,PAN Hao,et al.Intradural transcavernous surgical mangement of giant cavernous sinus hemangiomas[J].Journal of Clinical Neurosurgery,2020,17(01):42.

更新日期/Last Update: 2020-02-19