摘要
目的分析高血压脑出血(HICH)患者术后发生脑积水的相关因素。方法选取2016年6月至2020年12月在郑州煤炭工业(集团)有限责任公司总医院接受开颅血肿清除术治疗的256例HICH患者作为研究对象,术后2周,通过头颅CT评估患者脑积水发生情况。询问并记录患者基线资料,采用logistic回归模型分析HICH患者术后脑积水形成的相关因素。结果术后2周,经头颅CT检查结果显示,256例HICH患者中48例(18.75%)发生脑积水。发生组合并颅内感染占比、Graeb评分、血清肿瘤坏死因子-α(TNF-α)水平高于未发生组,术前格拉斯哥昏迷评分(GCS)低于未发生组(P<0.05)。两组体质量指数、入院时舒张压和收缩压、脑出血部位等基线资料比较,差异无统计学意义(P>0.05)。经logistic回归分析,合并颅内感染、Graeb评分高、血清TNF-α水平高是HICH患者术后发生脑积水的危险因素(OR>1,P<0.05);术前GCS评分高是患者术后发生脑积水的保护因素(OR<1,P<0.05)。结论HICH患者术后脑积水形成的相关因素为合并颅内感染、高Graeb评分、血清TNF-α高水平、高GCS评分。
Objective To analyze the influencing factors of postoperative hydrocephalus in patients with hypertensive intracerebral hemorrhage(HICH).Methods A total of 256 patients with HICH who underwent craniotomy and hematoma removal in the General Hospital of Zhengzhou Coal Industry(Group)Co.,Ltd.from June 2016 to December 2020 were selected as the study subjects.Two weeks after operation,the occurrence of hydrocephalus of patients was assessed by cranial CT examination.The baseline data of patients were inquired and recorded,and the related factors of postoperative hydrocephalus in patients with HICH were analyzed by logistic regression model.Results Two weeks after operation,cranial CT showed that 48 cases(18.75%)of 256 patients with HICH developed hydrocephalus.Compared with the non occurrence group,the proportion of combination with intracranial infection,the Graeb score and the level of serum serum tumor necrosis factor-α(TNF-α)of occurrence group were higher and the preoperative Glasgow coma scale(GCS)in the occurrence group was lower than that in the non occurrence group(P<0.05).There was no significant difference between the two groups in the baseline data such as body mass index,diastolic and systolic blood pressure at admission and cerebral hemorrhage site(P>0.05).The results of logistic regression analysis showed that intracranial infection,high Graeb score and high serum TNF-αlevel were the risk factors of postoperative hydrocephalus in patients with HICH(OR>1,P<0.05).High preoperative GCS score was a protective factor for the formation of postoperative hydrocephalus in patients(OR<1,P<0.05).Conclusion The related factors of postoperative hydrocephalus in patients with HICH were intracranial infection,high Graeb score,high GCS score and serum TNF-αhigh level.
作者
许银才
杨博
郑爱敏
XU Yincai;YANG Bo;ZHENG Aimin(Department of Neurosurgery,General Hospital of Zhengzhou Coal Industry(Group)Co.,Ltd.,Zhengzhou 452371,China)
出处
《河南医学研究》
CAS
2022年第18期3304-3306,共3页
Henan Medical Research
关键词
高血压脑出血
开颅血肿清除术
脑积水
相关因素
hypertensive intracerebral hemorrhage
removal of craniotomy hematoma
hydrocephalus
relevant factor
