临床神经外科杂志2019，Vol.16Issue(5)：369-375,7.DOI:10.3969／j.issn.1672-7770.2019.05.001
自发性脑出血破入脑室与否的预后比较分析
Prognostic comparison and analysis of spontaneous intracerebral hemorrhage with or without ventricular extension
摘要
Abstract
Objective To compare and analyze the influence of spontaneous intracerebral hemorrhage(sICH) on the prognosis of patients with or without ventricular extension.Methods The clinical data of 1 342 patients with sICH from 2010 to 2016 in The First Hospital Affiliated To AMU , who were divided into two groups according to whether it drainaged into ventricles , were analyzed retrospectively.Results Of 1 342 patients, 455 (33.9%) were with ventricular extension and 887 (66.1%) without.Statistically significant difference was found in group with ventricular extension whose average length of stay (25.1 ±26.7) d, mRS score at discharge [4 (3,5) points], mortality (14.1%), and group without ventricular extension whose average length of stay (20.9 ±21.8) d, mRS score at discharge [3 (2,4) points ], mortality (2.5%) ( P ＜0.05 ).Univariate logistic regression analysis showed that drainaged into ventricles ( OR ＝2.521, P＝0.000 ) was an independent risk factor for poor prognosis of patients with sICH.Multivariate logistic regression analysis of the group without ventricular extension and the group with ventricular extension showed that, the course of disease ＞24 h ( OR ＝0.566, P ＝0.001 vs OR ＝0.547, P＝0.032 ) were protective factors in both groups , admission GCS≤8 scores ( OR ＝5.146, P ＝0.004 vs OR ＝11.013,P＝0.000), irregular hematoma shape (OR＝2.053,P＝0.000 vs OR＝3.648,P＝0.000), pulmonary infection(OR＝2.356,P ＝0.000 vs OR＝1.994,P＝0.012) were both risk factors. The age, gender, hematoma volume, location, shape, density and admission GCS score of patients were analyzed by forest map subgroup , statistical difference was found only in subgroup of hematoma location(P＜0.05).Conclusions The prognosis of patients with sICH with ventricular extension is generally worse than that without ventricular extension.Ventricular extension is an independent risk factor of the prognosis of patients with sICH.The prognosis of patients with different hematoma location is significantly different in two groups.The course of disease ＞24 h is the prognostic protective factor in two groups , while admission GCS≤8 scores, pulmonary infection and irregular hematoma shape are the prognostic risk factors in both groups.关键词
自发性脑出血/破入脑室/预后Key words
spontaneous intracerebral hemorrhage / ventricular extension/ prognosis分类
医药卫生引用本文复制引用
夏捷生,冯建飞,李巧玲,张超,胡荣,冯华..自发性脑出血破入脑室与否的预后比较分析[J].临床神经外科杂志,2019,16(5):369-375,7.基金项目
国家重点基础研究发展计划(973计划)(2014CB5416003) （973计划）
国家自然科学基金(81671228) （81671228）
