摘要
目的分析自发性小脑出血患者术后发生脑疝的影响因素。方法选取28例行手术治疗的自发性小脑出血患者作为研究对象,观察记录患者手术预后结局,收集患者的性别、年龄、术前格拉斯哥昏迷量表(GCS)评分、合并感染、随机血糖、血压(收缩压、舒张压)、血肿最大直径、贫血、脑积水、肌酐、总胆固醇等情况,对自发性小脑出血患者术后发生脑疝的影响因素进行单因素及Logistic多因素回归分析。结果28例患者术后发生脑疝14例(脑疝组),未发生脑疝14例(非脑疝组)。脑疝组患者的年龄(72.86±10.80)岁、血肿最大直径(7.52±1.24)cm均大于非脑疝组的(64.93±7.65)岁、(6.42±1.36)cm,术前GCS评分(7.85±2.03)分低于非脑疝组的(9.71±1.92)分,合并感染率92.86%(13/14)、脑积水发生率85.71%(12/14)、收缩压(135.14±11.22)mm Hg(1 mm Hg=0.133 kPa)、随机血糖(8.39±2.03)mmol/L、肌酐(89.16±15.29)μmol/L、总胆固醇(6.69±1.11)mmol/L均高于非脑疝组的57.14%(8/14)、35.71%(5/14)、(122.86±14.77)mm Hg、(6.73±1.92)mmol/L、(75.25±14.61)μmol/L、(4.89±1.20)mmol/L,差异均有统计学意义(P<0.05)。两组性别、贫血发生率及舒张压比较差异无统计学意义(P>0.05)。经Logistic多因素回归分析显示,年龄大、术前GCS评分低、收缩压高、随机血糖高、肌酐高、总胆固醇高、脑积水是自发性小脑出血患者术后发生脑疝的独立危险因素(P<0.05)。结论年龄、GCS评分、收缩压、空腹血糖、肌酐、总胆固醇、脑积水是自发性小脑出血患者术后发生脑疝的独立危险因素,因此在治疗过程中应积极采取相关措施,将危险因素降至最低,以改善患者的预后情况。
Objective To analyze the factors influencing the development of postoperative brain herniation in patients with spontaneous cerebellar hemorrhage.Methods 28 patients with spontaneous cerebellar hemorrhage who underwent surgical treatment were selected as the research subjects,and the surgical prognosis of the patients was observed and recorded.Gender,age,preoperative Glasgow coma scale(GCS)score,co-infection,random blood glucose,blood pressure(systolic and diastolic blood pressure),maximum diameter of hematoma,anemia,hydrocephalus,creatinine,and total cholesterol were collected,and the factors influencing the occurrence of brain herniation in patients with spontaneous cerebellar hemorrhage after surgery were analyzed by univariate and Logistic multi-factor regression.Results Of the 28 patients,14 cases had brain herniation after surgery(brain herniation group),and 14 cases did not have brain herniation(non-brain herniation group).In the brain herniation group,the age(72.86±10.80)years old and the maximum diameter of the hematoma(7.52±1.24)cm were greater than(64.93±7.65)years old and(6.42±1.36)cm in the non-brain herniation group;the preoperative GCS score(7.85±2.03)points was lower than(9.71±1.92)points in the non-brain herniation group;the co-infection rate 92.86%(13/14)and the incidence of hydrocephalus 85.71%(12/14),systolic blood pressure(135.14±11.22)mm Hg(1 mm Hg=0.133 kPa),random blood glucose(8.39±2.03)mmol/L,creatinine(89.16±15.29)μmol/L,total cholesterol(6.69±1.11)mmol/L were higher than 57.14%(8/14),35.71%(5/14),(122.86±14.77)mm Hg,(6.73±1.92)mmol/L,(75.25±14.61)μmol/L,(4.89±1.20)mmol/L in the non-brain herniation group;all the differences were statistically significant(P<0.05).There were no statistically significant differences in gender,incidence of anemia and diastolic blood pressure between the two groups(P>0.05).Logistic multi-factor regression analysis showed that older age,low preoperative GCS score,high systolic blood pressure,high random blood glucose,high creatinine,high total cholesterol,and hydrocephalus were independent risk factors for postoperative cerebral herniation in patients with spontaneous cerebellar hemorrhage(P<0.05).Conclusion Age,GCS score,systolic blood pressure,fasting blood glucose,creatinine,total cholesterol,and hydrocephalus are independent risk factors for postoperative cerebral herniation in patients with spontaneous cerebellar hemorrhage.Therefore,relevant measures should be actively taken to minimize the risk factors during the treatment in order to improve the prognosis of patients.
作者
李永康
LI Yong-kang(Department of Neurosurgery,Pizhou Hospital of Traditional Chinese Medicine,Pizhou 221300,China)
出处
《中国实用医药》
2022年第16期47-50,共4页
China Practical Medicine
关键词
自发性小脑出血
脑疝
手术治疗
预后
影响因素
Spontaneous cerebellar hemorrhage
Brain herniation
Surgical treatment
Prognosis
Influencing factors
