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目的探讨脑出血患者急性期血肿扩大的危险因素。方法选取我院急诊科诊治的急性脑出血并存在急性血肿扩大的患者104例为观察组,同时段急性脑出血未继发急性血肿扩大的患者104例为对照组,分析其临床资料,比较二组患者病程、平均动脉压、首次出血量、血肿形态及患者病死率,对脑出血患者血肿扩大的危险因素进行分析,主要包括病程、平均动脉压、血肿形态、出血部位、出血量等。结果①与对照组比较,观察组患者病程短,平均动脉压显著升高,首次出血量大,血肿不规则比率高,差异均具有统计学意义(P<0.05)。②多因素Logistic回归分析显示病程、平均动脉压、血肿形态为脑出血急性期血肿扩大的危险因素。③观察组患者病死率为36.53%,对照组病死率为19.23%,观察组患者病死率显著高于对照组,差异有统计学意义(P<0.05)。结论病程、平均动脉压、血肿形态为脑出血急性期血肿扩大的危险因素,应该采取积极的防治措施。
Objective To explore the risk factors of hematoma enlargement in acute stage of cerebral hemorrhage. Methods A total of 104 patients with acute cerebral hemorrhage who had acute cerebral hemorrhage diagnosed and treated in our department were enrolled in the study group. Another 104 patients with acute hematoma enlargement in acute cerebral hemorrhage were selected as the control group. The clinical data of the two groups were compared, The course of the disease, the mean arterial pressure, the amount of first blood loss, the shape of the hematoma and the mortality of the patients were analyzed. The risk factors of the hematoma enlargement in the patients with cerebral hemorrhage were analyzed, including the course of the disease, the mean arterial pressure, the shape of the hematoma, the bleeding site and the amount of bleeding. Results ① Compared with the control group, the patients in the observation group had shorter duration, higher mean arterial pressure, larger first blood loss, and higher irregular hematoma rates (all P <0.05). ② Logistic regression analysis showed that the course of disease, the mean arterial pressure and the shape of hematoma were the risk factors for the enlargement of hematoma in the acute stage of cerebral hemorrhage. ③ The case-fatality rate was 36.53% in the observation group and 19.23% in the control group. The case-fatality rate in the observation group was significantly higher than that in the control group (P <0.05). Conclusions The course of disease, the mean arterial pressure and the shape of hematoma are the risk factors for the expansion of hematoma in the acute stage of cerebral hemorrhage. Therefore, we should take active prevention and treatment measures.