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目的分析急性脑出血患者发病早期血肿扩大的危险因素。方法选取2014年1月至2015年6月急性脑出血的患者316例。依据入院24 h内颅脑CT复查结果分为血肿扩大组118例和非血肿扩大组198例,比较两组患者一般情况、影像学检查指标、实验室检查指标,分析血肿扩大的危险因素。结果血肿扩大组饮酒史、入院时收缩压、入院时舒张压、意识障碍发生率均明显高于非血肿扩大组,差异有统计学意义(P<0.05)。两组破入脑室发生率、首次血肿量、非规则血肿形态比较差异均未见统计学意义(P>0.05);血肿扩大组空腹血糖>6.1 mmol/L比例高于非血肿扩大组,差异均有统计学意义(P<0.05)。经Logistic回归分析,空腹血糖水平、入院时收缩压、饮酒史为急性脑出血患者发病早期血肿扩大的独立危险因素(OR=8.992、3.846、7.359,P<0.05)。结论空腹血糖、入院时收缩压、饮酒史为急性脑出血患者发病早期血肿扩大的独立危险因素,在临床治疗中应加以重视。
Objective To analyze the risk factors of early hematoma expansion in patients with acute cerebral hemorrhage. Methods 316 patients with acute cerebral hemorrhage from January 2014 to June 2015 were selected. According to the results of craniocerebral CT examination within 24 hours after admission, the patients were divided into hematoma enlargement group (118 cases) and non-hematoma enlargement group (198 cases). The general conditions, imaging examination indexes and laboratory indexes of two groups were compared to analyze the risk factors of hematoma enlargement. Results The drinking history, the systolic blood pressure at admission, the diastolic blood pressure at admission, and the incidence of disturbance of consciousness were significantly higher in the hematoma enlargement group than those in the non-hematoma enlargement group (P <0.05). The rates of ventricular break-down, first hematoma, and irregular hematoma in two groups had no significant difference (P> 0.05). The fasting blood glucose> 6.1 mmol / L in hematoma enlargement group was higher than that in non-hematoma enlargement group There was statistical significance (P <0.05). Logistic regression analysis showed that fasting blood glucose level, systolic blood pressure at admission, and alcohol drinking history were independent risk factors of early hematoma expansion in patients with acute cerebral hemorrhage (OR = 8.992, 3.856, 7.359, P <0.05). Conclusion The fasting blood glucose, admission systolic blood pressure and alcohol drinking history are independent risk factors of early hematoma expansion in patients with acute cerebral hemorrhage and should be paid more attention in clinical treatment.