多中心复杂海拔差异人群自发性脑出血早期血肿扩大的影响因素分析

Influencing factors of early hematoma expansion in spontaneous cerebral hemorrhage in multicenter population with complex altitude differences

  • 摘要:
    目的 探讨自发性脑出血(SICH)患者早期血肿扩大(HE)的影响因素。
    方法 选取311例SICH患者为研究对象,根据HE发生情况分为扩大组和未扩大组。收集SICH患者临床评估指标,并比较2组一般资料。分析SICH患者发生HE的影响因素。
    结果 根据6~12 h内第2次CT检查是否出现HE, 将311例SICH患者分为扩大组(n=97)和未扩大组(n=214)。单因素分析显示, 2组患者的初始血肿体积、血肿边缘规则程度、格拉斯哥昏迷量表(GCS)评分、凝血功能以及漩涡征、分叶征、黑洞征、混杂征、淋巴细胞和中性粒细胞比较,差异有统计学意义(P<0.05)。多因素分析显示, GCS评分、初始血肿体积、抗血栓药物使用史、凝血功能异常和颅内CT征象是HE的独立影响因素(P<0.05)。
    结论 SICH患者HE的发生与GCS评分、初始血肿体积、抗血栓药物使用史、凝血功能异常和颅内CT征象密切相关。

     

    Abstract:
    Objective To investigate the influencing factors for early hematoma enlargement (HE) in patients with spontaneous intracerebral hemorrhage (SICH).
    Methods A total of 311 patients with SICH were selected as research subjects. Based on the occurrence of HE, they were divided into enlargement group and non-enlargement group. Clinical assessment indicators of patients with SICH were collected, and general information between the two groups was compared. The influencing factors for the occurrence of HE in patients with SICH were analyzed.
    Results Based on the presence of HE at a second CT examination within 6 to 12 hours, 311 patients with SICH were divided into enlargement group (n=97) and non-enlargement group (n=214). Univariate analysis revealed significant differences between the two groups in terms of initial hematoma volume, regularity of hematoma margin, Glasgow Coma Scale (GCS) score, coagulation function, as well as the presence of swirl sign, lobulation sign, black hole sign, blend sign, lymphocyte count and neutrophil count (P < 0.05). Multivariate analysis indicated that GCS score, initial hematoma volume, history of antithrombotic drug use, abnormal coagulation function and intracranial CT signs were independent influencing factors for HE (P < 0.05).
    Conclusion The occurrence of HE in patients with SICH is closely related to GCS score, initial hematoma volume, history of antithrombotic drug use, abnormal coagulation function and intracranial CT signs.

     

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