CAJ | 학술논문

目的：探讨高血压性脑出血术后神经功能和生活能力的影响因素。方法回顾性分析2013年3月至2015年3月在我院进行手术治疗的80例高血压脑出血患者的临床资料。采用日常生活活动能力(ADL)分级法将患者分为预后良好组(1~3级)与预后较差组(4~6级)，对两组的临床资料进行比较分析。结果根据ADL标准可将患者分为预后良好组47例和预后较差组33例。预后良好组与预后较差组患者术前GCS评分、出血量、术前瞳孔散大情况、血肿破入脑室情况及手术时机比较差异显著，有统计学意义(P＜0.05)，两组患者的性别、年龄及出血部位等情况比较差异不显著(P＞0.05)。 Logistic回归分析显示患者的术前GCS评分、出血量及出血破入脑室情况与患者的ADL分级具有相关性(P＜0.05)，相关系数分别是-0.455、0.123和0.340。结论出血量、术前GCS评分及出血破入脑室情况可作为对高血压性脑出血患者术后神经功能和生活能力评价的临床指标，而手术时机及术前瞳孔散大情况对其也有一定的影响，根据相关因素制定相应的治疗方案，对预后具有重要的临床意义。
목적：탐토고혈압성뇌출혈술후신경공능화생활능력적영향인소。방법회고성분석2013년3월지2015년3월재아원진행수술치료적80례고혈압뇌출혈환자적림상자료。채용일상생활활동능력(ADL)분급법장환자분위예후량호조(1~3급)여예후교차조(4~6급)，대량조적림상자료진행비교분석。결과근거ADL표준가장환자분위예후량호조47례화예후교차조33례。예후량호조여예후교차조환자술전GCS평분、출혈량、술전동공산대정황、혈종파입뇌실정황급수술시궤비교차이현저，유통계학의의(P＜0.05)，량조환자적성별、년령급출혈부위등정황비교차이불현저(P＞0.05)。 Logistic회귀분석현시환자적술전GCS평분、출혈량급출혈파입뇌실정황여환자적ADL분급구유상관성(P＜0.05)，상관계수분별시-0.455、0.123화0.340。결론출혈량、술전GCS평분급출혈파입뇌실정황가작위대고혈압성뇌출혈환자술후신경공능화생활능력평개적림상지표，이수술시궤급술전동공산대정황대기야유일정적영향，근거상관인소제정상응적치료방안，대예후구유중요적림상의의。
Objective To analyze the influence factors of nerve function and life ability of hypertensive cerebral hemorrhage after surgery. Methods Clinical data of 80 patients with hypertensive cerebral hemorrhage treated in our hospital from March 2013 to March 2015 were retrospectively analyzed. All patients were given surgical treatment and divided into good prognosis group (grade 1~3) and poor prognosis group (grade 4 ~ 6) according to the ability of daily life (ADL) classification method. The clinical data of patients in the two groups were compared and analyzed. Results 80 patients with hypertensive cerebral hemorrhage could be divided into good prognosis group (47 cases) and poor prognosis group (33 cases) according to the ADL criterion. The preoperative GCS score, bleeding volume, conditions of mydriasis, conditions of hematoma broken into ventricle and operation time of the two groups had statistical difference (P<0.05), the gender, age and bleeding location of the two groups had no statistical difference (P >0.05). The Logistic regression analysis showed that the preoperative GCS score, bleeding volume and conditions of hematoma broken into ventricle had correlation with patients' ADL classification (P<0.05), the correlation coefficient were-0.455, 0.123 and 0.340 respectively. Conclusions The preoperative GCS score, bleeding volume and conditions of hematoma broken into ventricle can serve as the clinical indices to evaluate the nerve function and life ability of patients with hypertensive cerebral hemorrhage after surgery. The operation time and conditions of mydriasis also have a certain effect on the nerve function and life ability of patients. Corresponding treatment plan should be formulated according to the related factors, which has important significance to prognosis.