高血压脑出血微创术后再出血的多因素分析及治疗策略
|
摘要
目的分析高血压性脑出血患者微创穿刺术后再出血的风险因素与相应的防治策略。方法回顾性分析2015年2月至2017年1月间在我院神经外科采用微创穿刺颅内血肿清除术治疗高血压脑出血203例患者的样本,对术后发生再出血21例的原因进行分析探讨,并针对原因找出相应的防治策略。结果本组203例患者中,发生再出血21例,再出血发生率为10.3%,研究发现术前血压分级、首次抽吸量、尿激酶的使用以及穿刺道损伤是导致高血压脑出血患者采用微创穿刺颅内血肿清除术治疗后再次出血的主要风险因素。结论经微创穿刺颅内血肿清除术治疗高血压脑出血患者术后再出血的影响因素多种且复杂,在术后要积极开展针对性的预防措施,以减少再出血的发生。
Objective To analyze the risk factors and corresponding prevention and treatment strategy of rebleeding after minimally invasive puncture in hypertensive intracerebral hemorrhage. Methods Totally 203 patients with hypertensive cerebral hemorrhage in the department of neurosurgery in our hospital from February 2015 to January 2017 received minimally invasive treatment of intracranial hematoma and their data were retrospectively analyze. The causes of rebleeding which occurred in 21 patients after operation were discussed,and the corresponding control strategies were studied. Results Among the 203 cases,rebleeding occurred in 21 cases,with the rebleeding rate 10. 3%. The preoperative blood pressure grading,first-time suction amount,the use of puncture urokinase and tract injury were the main risk factors of rebleeding in patients with hypertensive intracerebral hemorrhage after minimally invasive aspiration.Conclusion The influencing factors of rebleeding are various and complex for hypertensive intracerebral hemorrhage patients after minimally invasive puncture treatment,and targeted prevention measures should be actively carried out after the operation in order to reduce the occurrence of rebleeding.
Objective To analyze the risk factors and corresponding prevention and treatment strategy of rebleeding after minimally invasive puncture in hypertensive intracerebral hemorrhage. Methods Totally 203 patients with hypertensive cerebral hemorrhage in the department of neurosurgery in our hospital from February 2015 to January 2017 received minimally invasive treatment of intracranial hematoma and their data were retrospectively analyze. The causes of rebleeding which occurred in 21 patients after operation were discussed,and the corresponding control strategies were studied. Results Among the 203 cases,rebleeding occurred in 21 cases,with the rebleeding rate 10. 3%. The preoperative blood pressure grading,first-time suction amount,the use of puncture urokinase and tract injury were the main risk factors of rebleeding in patients with hypertensive intracerebral hemorrhage after minimally invasive aspiration.Conclusion The influencing factors of rebleeding are various and complex for hypertensive intracerebral hemorrhage patients after minimally invasive puncture treatment,and targeted prevention measures should be actively carried out after the operation in order to reduce the occurrence of rebleeding.
引文
[1]康强,周东,曾胜田,等.微创颅内血肿碎吸术治疗少量高血压脑出血[J].广东医学,2012,33(20):3103-3104.
[2]罗民新.3种手术方式治疗高血压脑出血临床分析[J].山东医药,2010,50(12):95-97.
[3]Brott T,Broderick J,Kothari R,et al.Early hemorrhage growth in patients with intracerebral hemorrhage[J].Stroke,1997,28(1):1-5.
[4]高林,孙志红,李欣舒,等.脑出血患者病死率与血压相关性的研究[J].华西医学,2013(3):331-333.
[5]贺传沙,鲁远君.高血压脑出血血肿扩大的危险因素[J].重庆医科大学学报,2011,36(11):1391-1393.
[6]金传兵,王贵春,李亚东.高血压脑出血后早期血肿扩大相关因素分析[J].安徽医学,2017,38(4):471-473.
[7]朱宗亚,朱向香,周元林,等.微创颅内血肿清除术患者远期预后的影响因素分析[J].实用医学杂志,2013,29(15):2512-2515.
[8]王亮,陈治强.超早期微创穿刺碎吸引流术治疗小量基底节区脑出血的疗效观察[J].重庆医学,2011,40(18):1838-1839.
[9]罗辉,魏林平,黄素玉.微创穿刺辅以尿激酶治疗高血压性脑出血患者对神经功能及预后的影响[J].岭南急诊医学杂志,2016,21(5):510-512.
[2]罗民新.3种手术方式治疗高血压脑出血临床分析[J].山东医药,2010,50(12):95-97.
[3]Brott T,Broderick J,Kothari R,et al.Early hemorrhage growth in patients with intracerebral hemorrhage[J].Stroke,1997,28(1):1-5.
[4]高林,孙志红,李欣舒,等.脑出血患者病死率与血压相关性的研究[J].华西医学,2013(3):331-333.
[5]贺传沙,鲁远君.高血压脑出血血肿扩大的危险因素[J].重庆医科大学学报,2011,36(11):1391-1393.
[6]金传兵,王贵春,李亚东.高血压脑出血后早期血肿扩大相关因素分析[J].安徽医学,2017,38(4):471-473.
[7]朱宗亚,朱向香,周元林,等.微创颅内血肿清除术患者远期预后的影响因素分析[J].实用医学杂志,2013,29(15):2512-2515.
[8]王亮,陈治强.超早期微创穿刺碎吸引流术治疗小量基底节区脑出血的疗效观察[J].重庆医学,2011,40(18):1838-1839.
[9]罗辉,魏林平,黄素玉.微创穿刺辅以尿激酶治疗高血压性脑出血患者对神经功能及预后的影响[J].岭南急诊医学杂志,2016,21(5):510-512.