中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2013年
2期
171-174
,共4页
陈都%王卫广%陆士奇%徐峰
陳都%王衛廣%陸士奇%徐峰
진도%왕위엄%륙사기%서봉
创伤性脑出血%术后再出血%危险因素
創傷性腦齣血%術後再齣血%危險因素
창상성뇌출혈%술후재출혈%위험인소
Traumatic intracerebral hemorrhage%Postoperative intracerebral re-hemorrhage%Risk factor
目的 通过回顾性病例对照研究方法分析创伤性脑出血患者相关临床指标以筛选出术后再出血的危险因素. 方法 收集自2007年1月至201 1年9月在苏州大学附属第一医院住院的237例创伤性脑出血患者病历资料,按是否发生出血分为术后再出血组84例和术后未出血组153例.对患者11个临床指标进行单因素、多因素Logistic回归分析,筛选出独立危险因素,并通过受试者工作特征曲线(ROC)分析其预测价值. 结果 单因素分析显示发病到手术时间、颅内血肿量、凝血酶时间、血清前白蛋白水平、血糖水平在术后再出血组和术后未出血组间比较差异有统计学意义(P＜0.05)；多因素分析血清前白蛋白水平(P=0.0 16,OR=0.994,95％CI:0.988～0.999)、凝血酶时间(P=0.044,OR=1.114,95％CI:1.003～1.238)及血肿量(P=0.003,OR=1.020,95％CI:1.007～1.033)是创伤性脑出血术后再出血的独立危险因素,且ROC曲线分析表明三者对其发生均有一定的预测价值. 结论 血清前白蛋白水平降低、凝血酶时间延长及血肿量大的创伤性脑出血患者术后再出血的发生风险大,需密切监护,及早进行临床干预.
目的 通過迴顧性病例對照研究方法分析創傷性腦齣血患者相關臨床指標以篩選齣術後再齣血的危險因素. 方法 收集自2007年1月至201 1年9月在囌州大學附屬第一醫院住院的237例創傷性腦齣血患者病歷資料,按是否髮生齣血分為術後再齣血組84例和術後未齣血組153例.對患者11箇臨床指標進行單因素、多因素Logistic迴歸分析,篩選齣獨立危險因素,併通過受試者工作特徵麯線(ROC)分析其預測價值. 結果 單因素分析顯示髮病到手術時間、顱內血腫量、凝血酶時間、血清前白蛋白水平、血糖水平在術後再齣血組和術後未齣血組間比較差異有統計學意義(P＜0.05)；多因素分析血清前白蛋白水平(P=0.0 16,OR=0.994,95％CI:0.988～0.999)、凝血酶時間(P=0.044,OR=1.114,95％CI:1.003～1.238)及血腫量(P=0.003,OR=1.020,95％CI:1.007～1.033)是創傷性腦齣血術後再齣血的獨立危險因素,且ROC麯線分析錶明三者對其髮生均有一定的預測價值. 結論 血清前白蛋白水平降低、凝血酶時間延長及血腫量大的創傷性腦齣血患者術後再齣血的髮生風險大,需密切鑑護,及早進行臨床榦預.
목적 통과회고성병례대조연구방법분석창상성뇌출혈환자상관림상지표이사선출술후재출혈적위험인소. 방법 수집자2007년1월지201 1년9월재소주대학부속제일의원주원적237례창상성뇌출혈환자병력자료,안시부발생출혈분위술후재출혈조84례화술후미출혈조153례.대환자11개림상지표진행단인소、다인소Logistic회귀분석,사선출독립위험인소,병통과수시자공작특정곡선(ROC)분석기예측개치. 결과 단인소분석현시발병도수술시간、로내혈종량、응혈매시간、혈청전백단백수평、혈당수평재술후재출혈조화술후미출혈조간비교차이유통계학의의(P＜0.05)；다인소분석혈청전백단백수평(P=0.0 16,OR=0.994,95％CI:0.988～0.999)、응혈매시간(P=0.044,OR=1.114,95％CI:1.003～1.238)급혈종량(P=0.003,OR=1.020,95％CI:1.007～1.033)시창상성뇌출혈술후재출혈적독립위험인소,차ROC곡선분석표명삼자대기발생균유일정적예측개치. 결론 혈청전백단백수평강저、응혈매시간연장급혈종량대적창상성뇌출혈환자술후재출혈적발생풍험대,수밀절감호,급조진행림상간예.
Objective To investigate the risk factors of postoperative intracerebral re-hemorrhage of patients with traumatic intracerebral hemorrhage by analyzing the clinic factors through case control study.Methods Clinical data of 237 patients with traumatic intracerebral hemorrhage,admitted to our hospital from January 2007 to September,were collected; these patients were divided into postoperative intracerebral re-hemorrhage group (n=84) and non-postoperative intracerebral re-hemorrhage group (n=153) according to the re-hemorrhage; the 11 independent risk factors were proved by univariate and multivariate binary logistic regression analysis,of which predicting value was evaluated by receiver operating characteristic (ROC) curve.Results Univariate binary logistic regression analysis indicated that 5 factors as the time from injure to operation,volume of intracranial hematoma (VOL),thrombin time (TT),prealbumin (PAB) and blood sugar were significantly different between patients with postoperative intracerebral re-hemorrhage and patients without postoperative intracerebral re-hemorrhage (P＜0.05).Multivariate binary logistic regression analysis indicated that PAB (P=0.016,OR=0.994,95％CI:0.988-0.999),TT (P=0.044,OR=1.114,95％CI:1.003-1.238) and VOL (P=0.003,OR=1.020,95％CI:1.007-1.033) were the independent risk factors of postoperative intracerebral re-hemorrhage of patients with traumatic intracerebral hemorrhage,and ROC curve indicated that all these three factors had predictive value.Conclusion Patients with low PAB,prolonged TT or large VOL have higher risk of postoperative intracerebral re-hemorrhage; more attention should be paid on these patients to prevent intracerebral hemorrhage recurrence.
