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[自发性脑出血的预后因素]

[Prognostic factors in spontaneous intracerebral hemorrhage].

作者信息

Castillo J, Leira R, Martínez F, Corredera E, Aldrey J M, Noya M

机构信息

Departamento de Medicina, Hospital Xeral de Galicia, Clínico Universitario, Universidad de Santiago de Compostela.

出版信息

An Med Interna. 1994 Jul;11(7):318-21.

PMID:7981357
Abstract

The introduction of etiological, diagnostic and therapeutical factors have modified the knowledge on the evolutive behaviour of spontaneous intracerebral hemorrhages (ICH). Mortality and morbidity associated to spontaneous ICH were assessed using as independent variables clinical and neuroimage factors obtained upon admission of the patients. We studied 228 patients with spontaneous ICH selected from a data bank of 277 patients with non-traumatic ICH. During the first 24 hours, we assessed several clinical factors (arterial hypertension, Glasgows Neurological Scale and Barthels Scale) and TC images (size, location, extension of bleeding to ventricles, edema and atrophy). Thirty-one per cent of the patients died during the first 2 months. The multiple linear regression study showed that mortality was related to variables of the Glasgows Neurological Scale upon admission, extension to ventricles, size of ICH and perilesional edema, whereas the morbidity was only related to the size of the hemorrhage. Severity of the clinical affection, extension of the bleeding to ventricles, size of the hemorrhage and presence of perilesional edema, but not arterial hypertension, were the main factors affecting mortality at two months of spontaneous ICH.

摘要

病因、诊断和治疗因素的引入改变了对自发性脑出血(ICH)演变行为的认识。以患者入院时获得的临床和神经影像因素作为自变量,评估与自发性ICH相关的死亡率和发病率。我们从277例非创伤性ICH患者的数据库中选取了228例自发性ICH患者进行研究。在最初的24小时内,我们评估了多个临床因素(动脉高血压、格拉斯哥神经量表和巴塞尔量表)以及CT图像(大小、位置、出血扩展至脑室情况、水肿和萎缩)。31%的患者在最初2个月内死亡。多元线性回归研究表明,死亡率与入院时格拉斯哥神经量表的变量、出血扩展至脑室情况、ICH大小和病灶周围水肿有关,而发病率仅与出血大小有关。临床病情严重程度、出血扩展至脑室情况、出血大小和病灶周围水肿的存在,而非动脉高血压,是影响自发性ICH两个月死亡率的主要因素。

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