摘要： 目的 探讨脑脊液/脑内室体积（CSF/ICV）对高血压性脑出血患者立体定向微创穿刺引流术后再出血的预测价值。方法 选取2014年1月至2018年11月贵州医科大学附属第二医院行立体定向微创穿刺引流术治疗的308例高血压性脑出血患者，分析患者各项临床指标与术后再出血的相关性。结果 308例患者术后再出血46例（14.94%）。再出血患者术前CSF/ICV和颅内压均显著高于未再出血患者（P < 0.05）；CSF/ICV和颅内压呈正相关（r=0.882，P < 0.05）。单因素分析显示再出血患者和非再出患者手术时机、术后血压存在统计学差异（均P < 0.05）。二分类多因素logistic分析结果显示CSF/ICV（OR=0.872，P < 0.001）、术后血压（OR=0.624，P < 0.001）是影响高血压脑出血患者术后再出血的危险因素，手术时机（OR=0.701，P=0.001）是影响高血压脑出血患者术后再出血的保护性因素。结论 CSF/ICV与术后血压、手术时机一样，可作为高血压性脑出血患者术后再出血的预测因素。

脑脊液/脑内室体积对高血压性脑出血患者立体定向微创穿刺引流术后再出血的预测价值

吴昌松¹, 张波²

1. 贵州医科大学附属第二医院神经内科, 贵州 凯里 556000;
2. 贵阳中医学院附属第一医院神经外科, 贵阳 550001

收稿日期:2019-10-11出版日期:2020-08-30发布日期:2020-08-04
通讯作者:张波E-mail:635638540@qq.com
作者简介:吴昌松(1982-),男,主治医师,本科.
基金资助:贵州省中医药管理局中医药、民族医药科学项目（qzyy2017-034）


关键词: 高血压性脑出血, 立体定向微创穿刺引流术, 再出血, 脑脊液, 脑内室体积
Abstract: Objective To investigate the predictive value of cerebrospinal fluid/intra-cerebroventricular volume (CSF/ICV) on rebleeding in patients with hypertensive intracerebral hemorrhage after stereotactic minimally invasive puncture and drainage. Methods Three hundred and eight patients with hypertensive cerebral hemorrhage who underwent stereotactic minimally invasive puncture and drainage at our hospital from January 2014 to November 2018 were included. The correlation between the clinical indicators and postoperative rebleeding was analyzed. Results There were 46 cases (14.94%) of rebleeding. The preoperative CSF/ICV and intracranial pressure were significantly higher in patients with rebleeding than in those without rebleeding (P < 0.05). CSF/ICV was positively correlated with intracranial pressure (r=0.882,P < 0.05). Univariate analysis showed that there were statistical differences in operation timing and postoperative blood pressure between the patients with and without rebleeding (all P < 0.05). The results of the multivariate logistic analysis showed that CSF/ICV (OR=0.872,P < 0.001) and postoperative blood pressure (OR=0.624,P < 0.001) were risk factors for postoperative rebleeding in patients with hypertensive intracerebral hemorrhage,and the timing of surgery (OR=0.701,P=0.001) was a protective factor for postoperative rebleeding in patients with hypertensive intracerebral hemorrhage. Conclusion CSF/ICV,postoperative blood pressure,and surgical timing can be used as predictors of postoperative rebleeding in patients with hypertensive intracerebral hemorrhage.
Key words: hypertensionsive intracerebral hemorrhage, stereotactic minimally invasive puncture and drainage, rebleeding, cerebrospinal fluid, intra-cerebroventricular volume
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