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目的探讨影响高血压脑出血血肿扩大的相关因素。方法 124例急性期高血压脑出血患者,根据是否出现血肿扩大分为血肿扩大组38例和非血肿扩大组86例,对比分析发病到入院的时间、入院时的血压、出血部位和血肿形态等因素与血肿扩大的关系。结果 124例脑出血患者有38例发生血肿扩大,发生率为30.65%,其中发病6h以内为40.00%,6～24h为35.71%,24～48h为16.67%,48h以上为6.67%。血肿扩大组收缩压≥180mmHg者占52.63%,非血肿扩大组占19.77%,血肿扩大组舒张压≥110mmHg,占47.37%,非血肿扩大组占23.26%,两组比较血肿扩大组舒张压及收缩压均明显高于非血肿扩大组。血肿扩大组基底节出血占50%,丘脑出血占34.21%,脑叶出血占10.52%,小脑出血占5.26%%;其中血肿形态不规则型占72.22%,规则型占22.73%,统计学有差异(P<0.01)。结论发病早期(24h内)、血压升高(收缩压≥180mmHg和舒张压≥110mm-Hg)、基底节区出血、血肿形态不规则是高血压脑出血的危险因素。
Objective To investigate the related factors that affect the enlargement of hematoma in hypertensive intracerebral hemorrhage. Methods A total of 124 patients with acute hypertensive intracerebral hemorrhage were divided into 38 cases of hematoma expansion and 86 cases of non-hematoma enlargement according to whether hematoma enlargement occurred or not. The incidence and admission time, blood pressure, bleeding site and hematoma morphology Relationship between factors and hematoma enlargement. Results Thirty-eight patients with cerebral hemorrhage had hematoma enlarged in 30 cases, the incidence was 30.65%. The incidence was 40.00% in 6 hours, 35.71% in 6-24 hours, 16.67% in 24-48 hours and 6.67% in 48 hours. Hematoma enlargement group with systolic blood pressure ≥180mmHg accounted for 52.63%, non-hematoma enlargement group accounted for 19.77%, hematoma enlargement group diastolic blood pressure ≥110mmHg, accounting for 47.37%, non-hematoma enlargement group accounted for 23.26%, two groups compared hematoma enlargement group diastolic pressure and contraction Pressure were significantly higher than non-hematoma enlargement group. Hematoma enlargement group basal ganglia hemorrhage accounted for 50%, thalamic haemorrhage accounted for 34.21%, lobar hemorrhage accounted for 10.52%, cerebellar hemorrhage accounted for 5.26 %%; of which irregular hematoma accounted for 72.22%, regular accounted for 22.73%, statistically significant differences (P <0.01). Conclusions Early onset (24h), elevated blood pressure (systolic blood pressure≥180mmHg and diastolic blood pressure≥110mm-Hg), basal ganglia hemorrhage and irregular hematoma are risk factors for hypertensive intracerebral hemorrhage.