微创颅内血肿抽吸引流术早期预后影响因素分析

摘要/Abstract

摘要：

目的探讨微创颅内血肿抽吸引流术治疗幕上脑出血的近期手术疗效，并寻找影响近期手术疗效的相关因素。方法收集自2010年7月至2014年2月收入首都医科大学附属北京天坛医院神经内科重症监护室，接受微创颅内血肿抽吸引流术的幕上脑出血患者作为研究对象，收集了卒中危险因素、血液学指标、患者的临床特征及手术相关信息，并随访患者术后30 d或出院时格拉斯哥评分（Glasgow score，GCS），通过单因素分析及多因素Logistic回归分析，寻找对近期手术疗效有影响的因素。结果入组患者共94例，其中男性60例，年龄23～84岁，平均（54.85±12.70）岁。术后30 d/出院时预后，清醒或轻度意识障碍（GCS 13～15分）者62例（65.9%），中重度意识障碍（GCS≤12分）或死亡者32例（34.1%）。多因素Logistic回归分析中年龄较高（OR 1.06，95%CI 1.00～1.12）、术前GCS较低（OR 0.59，95%CI 0.43～0.80）是患者预后不良的独立预测因素。结论微创颅内血肿抽吸引流术治疗幕上脑出血的短期预后不良与患者年龄较高、术前GCS评分低有关。

文章导读： 本研究显示微创颅内血肿抽吸引流术治疗幕上脑出血的手术短期疗效与年龄和术前格拉斯哥评分（Glasgow score，GCS）有关。

关键词: 脑出血; 微创颅内血肿抽吸引流术; 治疗; 预后

Abstract:

Objective To investigate the prognosis of supratentorial intracerebral hemorrhage afterminimal invasive hematoma aspiration and fibrinolysis and find out the influential factors. Methods Patients who were diagnosed as supratentorial intracerebral hemorrhage and underwent minimal invasive hematoma aspiration and fibrinolysis in Beijing Tiantan Hosipital were enrolled from July 2010 to February 2014. Clinical data such as: risk factors of stroke, chemical examination of blood, clinical features and information of surgical procedure were collected. The prognosis (Glasgow score, GCS) at 30-day after operation/discharge from hospital were followed up, and Logistic regression analysis was used to find out factors that influence early prognosis. Results Total 94 patients were enrolled in this study (60 were male), aged from 23 to 84 years (mean age 54.85±12.70). Sixty-two patients were alertness or mild consciousness disorders(GCS 13-15) (65.9%) at 30 day after operation/discharge from hospital, 32 patients were death or GCS≤12(34.1%). Logistic regression analysis showed that age, preoperative GCS were the independent predictors of prognosis. Conclusion Minimal invasivehematoma aspiration and fibrinolysis is a better minimally invasive method which deserves popularizing.

Key words: Cerebral hemorrhage; Minimal invasive hematoma aspiration andfibrinolysis;
Treatment; Prognosis

杨波，王晶，温淼，宋新杰，刘丽萍，杨中华，赵性泉. 微创颅内血肿抽吸引流术早期预后影响因素分析[J]. 中国卒中杂志, 2015, 10(11): 947-952.

YANG Bo, WANG Jing, WEN Miao, et al.. Analysis of Factors Correlated with Early Prognosis of Minimal Invasive Hematoma Aspiration and Fibrinolysis[J]. Chinese Journal of Stroke, 2015, 10(11): 947-952.

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