关键词: 高血压; 脑出血; 经额部锥孔引流; 再出血; 危险因素

Abstract:

Objective To investigate the risk factors for rehaemorrhagia after hypertension cerebral hemorrhage treatment by the frontal drainage cone, so as to provide clinical reference. Methods Retrospective analysis was used based on data of patients who had rehaemorrhagia after the frontal drainage cone treatment of hypertension cerebral hemorrhage from January 2013 to February 2015 in People′s Hospital of Qinglong. Patients' gender, age, preoperative blood pressure, blood glucose, blood lipid level, body mass index, preoperative hematoma volume, blood coagulation function, preoperative Glasgow Coma Scale (GCS) score, Montreal Cognitive Assessment (MoCA) scores, the United States National Institutes of Health Stroke Scale (NIHSS) scores, time between onset and operation, intraoperative bleeding were recorded. The multifactor and single factor Logistic regression analysis were used to analyze risk factors for rehaemorrhagia after frontal cone hole drainage treatment of hypertensive cerebral hemorrhage. Results A total of 100 cases were collected, including 15 cases of postoperative bleeding. The occurrence rate was 15.0%. The single factor analysis results showed that systolic blood pressure [(125±12) mmHg vs (146±17) mmHg, P <0.001], preoperative hematoma volume [(58.7±4.5) ml vs (63.4±6.2) ml, P <0.001], the time between onset to operation [5.1 (6.0) h vs 6.9 (6.2) h, P <0.001],

intraoperative with active bleeding [11 (12.9%) vs 9 (60.0%), P <0.001], and postoperative blood pressure control rate [60 (70.6%) vs 3 (20.0%), P <0.001] between non-rehaemorrhagia group and rehaemorrhagia group had significant differences. Multifactor Logistic regression analysis showed that large preoperative hematoma volume [OR 1.035, 95%CI (1.008, 2.359)], long duration between onset and operation [OR 1.289, 95%CI (1.027, 6.325)], intraoperative active bleeding [OR 2.154, 95%CI (1.067, 3.245)] were risk factors for rehaemorrhagia after the frontal cone hole drainage treatment of hypertensive cerebral hemorrhage, and the postoperative blood pressure control [OR 0.147, 95%CI (0.004, 0.358)] was the protective factor. Conclusion Large hematoma volume, long duration between onset and operation, intraoperative with active bleeding, uncontrolled postoperative blood pressure are risk factors for patients underwent frontal drainage cone treatment of hypertension cerebral hemorrhage after the high incidence of bleeding.

Key words: Hypertension; Cerebral hemorrhage; Frontal drainage cone; Rehaemorrhagia; Riskfactor