脑出血血肿扩大临床评分标准研究.docVIP

脑出血血肿扩大临床评分标准的研究 　　[摘要]目的 研究脑出血血肿扩大（ICH Growth）的相关因素，并建立一个方便、可行、有效的ICH Growth临床评分标准。方法 回顾性分析我院2009～2012年入院治疗的ICH患者300例（推导组）的临床资料，使用多因素Logistic回归分析等统计理论分析评估，建立临床评分标准，选取2013～2015年我院接诊的ICH患者80例作为验证组，收集临床资料并进行验证。结果 380例患者中ICH Growth患者199例，平均舒张压（DBP）（109±7）mmHg，平均收缩压（SBP）（201±15）mmHg，无血肿扩大患者平均DBP（105±6）mmHg，平均SBP（183±13）mmHg。两组平均SBP比较，差异有统计学意义（P0.05）。多因素Logistic分析结果表明酗酒史、抗凝剂治疗、发病至首次CT检查的时间及血肿形态和ICH Growth呈正相关。验证组的ICH Growth预计发生例数和实际发生例数之间无统计学差异（χ2=2.8876，P=0.5768）。结论 由酗酒史、发病至首次CT检查的时间、抗凝剂治疗、血肿形态四个危险因素组成的临床评分标准可以较好地预测ICH Growth的发生 [关键词]脑出血；血肿扩大；临床评分标准 [中图分类号] R743 [文献标识码] A [文章编号] 1674-4721（2016）08（a）-0043-03 [Abstract]Objective To study the related factors of intracerebral hemorrhage （ICH） Growth，then establish a convenient，feasible and effective ICH Growth clinical scoring standard.Methods The clinical data of 300 patients with ICH （induce group） admitted to our hospital from 2009 to 2012 were retrospectively analyzed，the multivariate Logistic regression and other statistical analysis were used to analysis，after the establishment of clinical evaluation standard，80 patients with ICH admitted to hospital from 2013 to 2015 were selected as validated group.Results In 380 patients with ICH，199 patients with hematoma enlargement，their mean diastolic blood pressure （DBP） was （109±7） mmHg，mean systolic blood pressure （SBP） was （201±15） mmHg，while average DBP of patients without hematoma enlargement was （105±6） mmHg，mean SBP with （183±13） mmHg；average SBP was statistically significant in two groups （P0.05）.The results of multivariate Logistic regression analysis indicated that drinking history，time from onset to first CT check，anticoagulant therapy and shape of hematoma were positively correlated with ICH Growth.The expected cases and the actual cases of ICH Growth in validation group were no significant difference （χ2=2.8876，P=0.5768）.Conclusion By drinking history，time from onset to first CT check，anticoagulant therapy， shape of hematoma four risk factors clinical crit