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目的 :探讨影响微创法清除颅内血肿术治疗高血压脑出血预后因素。方法 :对 32例高血压脑出血微创清除颅内血肿术的临床资料 ,采用多因素逐步回归法进行统计学处理。结果 :32例患者术后存活 2 6例 ,占 81.2 % ,死亡 6例 ,占18.8%。在单因素分析中 ,出血至手术时间 ,意识与脑疝征 ,瞳孔改变、出血部位、出血量及中线移位与预后有关 ,但只有 4项 (出血至手术时间、意识与脑疝征、瞳孔改变、中线移位 )被引入回归方程。结论 :出血至手术时间、意识与脑疝征、瞳孔改变、中线移位 4项因素 ,对微创清除颅内血肿术治疗高血压脑出血患者 ,具有显著的预后价值 ,超早期手术是治疗成功的关键。
Objective: To investigate the factors affecting the prognosis of hypertensive intracerebral hemorrhage (ICH) treated with minimally invasive intracranial hematoma. Methods: The clinical data of 32 cases of hypertensive intracerebral hemorrhage minimally invasive intracranial hematoma were collected, and were statistically analyzed by multi-factor stepwise regression. Results: 32 patients survived 26 cases, accounting for 81.2%, 6 died, accounting for 18.8%. In univariate analysis, bleeding to surgery time, consciousness and hernia sign, pupil changes, bleeding sites, bleeding volume and median line shift and prognosis, but only 4 (bleeding to surgery time, consciousness and hernia sign, pupil Change, midline shift) is introduced into the regression equation. CONCLUSION: The four factors of hemorrhage to operation time, consciousness and hernia sign, pupil change and midline displacement have significant prognostic value in patients with hypertensive intracerebral hemorrhage after minimally invasive removal of intracranial hematoma. Ultra-early surgery is successful in treatment key.