Celikbilek Asuman, Goksel Basak Karakurum, Zararsiz Gokmen, Benli Sibel
Department of Neurology, Baskent University Hospital, Ankara, Turkey.
J Neurosci Rural Pract. 2013 Jul;4(3):271-7. doi: 10.4103/0976-3147.118770.
Stroke, which remains the third leading cause of death after heart disease and cancer in developed countries, is a disorder causing permanent neurologic disability. Even though, hemorrhagic strokes are seen less than the ischemic type, they are more fatal. We studied the risk factors for spontaneous intra-cerebral hemorrhage (ICH) to direct the proper preventive treatment modalities and the effects of these factors on mortality as well as applied therapeutic strategies on survival.
The archive records of 106 patients (60 male, 46 female) who were diagnosed with spontaneous ICH in Baskent University Hospital, Ankara, between January 2003 and September 2008, were assessed retrospectively.
The mean age was found as 62.5. The most frequent risk factor was hypertension (73.5%); 69.2% of these hypertensive patients had uncontrolled blood pressure levels. The mortality rate was detected as 34.9% and patients were found to die approximately within 9 days after ICH. Older age, increased hemorrhage volume, ventricular extension of hemorrhage, and the presence of midline shift were found to significantly correlate with increased mortality (P < 0.05). Patients who underwent surgical therapy showed a longer survival rate (P = 0.016); however, no association was found between medical and surgical therapy in terms of mortality (P = 0.555).
The results of this study suggest that effective control of blood pressure is important in the prevention of spontaneous ICH; clinical and radiological findings with treatment modalities influencing mortality should be carefully managed.
在发达国家,中风仍是继心脏病和癌症之后的第三大死因,是一种可导致永久性神经功能残疾的疾病。尽管出血性中风的发生率低于缺血性中风,但前者的致死性更强。我们研究了自发性脑出血(ICH)的危险因素,以指导采取适当的预防性治疗方式,以及这些因素对死亡率的影响,同时还研究了应用的治疗策略对生存率的影响。
回顾性评估了2003年1月至2008年9月期间在安卡拉巴什肯特大学医院被诊断为自发性ICH的106例患者(60例男性,46例女性)的档案记录。
发现平均年龄为62.5岁。最常见的危险因素是高血压(73.5%);这些高血压患者中有69.2%的血压水平未得到控制。检测到死亡率为34.9%,且患者在ICH后约9天内死亡。发现年龄较大、出血量增加、出血破入脑室以及存在中线移位与死亡率增加显著相关(P<0.05)。接受手术治疗的患者生存率更长(P = 0.016);然而,在死亡率方面,药物治疗和手术治疗之间未发现关联(P = 0.555)。
本研究结果表明,有效控制血压对预防自发性ICH很重要;应仔细管理影响死亡率的临床和影像学检查结果以及治疗方式。