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目的探讨引起高血压脑出血早期血肿扩大的发生率、发生时间、影响因素及防治措施,以指导临床诊治。方法回顾性分析本院发病3h内的急性期高血压脑出血患者122例分为血肿扩大组(31例)和血肿稳定组(91例),对两组患者病史、临床特点、生化指标及头颅CT特征进行对比分析。结果脑出血早期血肿扩大的发生率为25.4%,发生时间多在发病后24h内(70.93%);基底节区不规则血肿、血压持续升高、肝功能受损、大量饮酒及长期服用抗血小板聚集药物的患者,易发生血肿扩大,两组比较有显著性差异(P<0.05)。结论脑出血后血肿增大多发生在24h内,长期口服抗血小板聚集药物、发病后血压持续增高、基底节区不规则血肿、肝功能受损可能为血肿增大的主要危险因素。
Objective To investigate the incidence of hypertensive intracerebral hemorrhage early hematoma expansion, occurrence time, influencing factors and prevention and treatment measures to guide clinical diagnosis and treatment. Methods A retrospective analysis of 122 cases of acute hypertensive intracerebral hemorrhage within 3h after onset of our hospital was divided into hematoma enlargement group (31 cases) and stable hematoma group (91 cases). The clinical history, clinical features, biochemical indexes and head CT features comparative analysis. Results The incidence of hematoma enlargement was 25.4% in early stage of hemorrhage and occurred more frequently within 24 hours after onset (70.93%). The hematoma in basilar area was irregular, hematoma continued to increase, liver function was impaired, heavy drinking and long-term antiplatelet Aggregation of patients with drug-prone hematoma expansion, the two groups were significantly different (P <0.05). Conclusions The increase of hematoma after intracerebral hemorrhage occurs mostly within 24 hours. Long-term oral administration of antiplatelet drugs increases the blood pressure after onset. The irregular hematoma in basal ganglia and the impaired liver function may be the main risk factors for the increase of hematoma.