摘要： 目的 探讨4500 m以上超高海拔地区脑出血患者血肿量及预后的影响因素。方法 收集2017年1月至2022年1月那曲市人民医院神经外科住院治疗的126例脑出血患者的临床资料，包括性别、年龄、民族、病史、出血部位及入院体征等指标，采用线性回归分析各指标与血肿量的相关性，多元线性回归分析血肿量的影响因素。根据预后情况将患者分为预后不良组、预后良好组，采用t检验或χ²检验比较2组各项指标的差异，将单因素分析有统计学意义（P<0.05）指标纳入多因素logistic回归分析预后的影响因素。结果 患者入院时收缩压、入院血红蛋白（HGB）、入院红细胞压积（HCT）与血肿量存在相关性，多元线性回归分析显示入院时收缩压是血肿量的影响因素（P<0.05）。预后良好组与预后不良组入院时血肿量、是否脑疝、入院时HCT及格拉斯哥昏迷评分（GCS）比较差异均具有统计学意义（均P<0.05）；多因素logistic回归分析显示，入院GCS评分和入院HCT是患者预后的独立危险因素（均P<0.05）。结论 超高海拔地区脑出血患者入院时收缩压是血肿量的影响因素，收缩压越高，血肿量越大。入院时GCS评分和HCT可能会影响患者的预后。

超高海拔地区脑出血患者血肿量及预后的影响因素

班允超¹, 朗觉², 吴亮², 多吉², 刘辉², 尼玛欧珠²

1. 中国医科大学附属第一医院神经外科, 沈阳 110001;
2. 那曲市人民医院外二科, 西藏 那曲 852000

收稿日期:2022-10-13出版日期:2023-03-30发布日期:2023-03-21
通讯作者:班允超E-mail:byc1664@sina.cm
作者简介:班允超(1982-),男,副主任医师,博士.
基金资助:辽宁省自然科学基金（2019-MS-08）


关键词: 超高海拔地区, 脑出血, 预后, 影响因素
Abstract: Objective To investigate the factors that affect hematoma volume and the prognosis of intracerebral hemorrhage in an area above 4500 m at an ultrahigh altitude. Methods A total of 126 patients with cerebral hemorrhage were hospitalized from January，2017 to January，2022 in the Department of Neurosurgery of People's Hospital of Naqu；the patients’ sex，age，nation，medical history，location of hemorrhage，and admission signs were collected，and the correlation between the patients and the volume of hematoma was analyzed. The patients were divided into two groups according to their prognosis，and the different characteristics were analyzed using t test or chi-square test. Multivariate logistic regression was used to measure the influence of meaningful independent variables on prognosis. Results Through linear regression，the patients’ systolic blood pressure，admission hemoglobin value，hematocrit （HCT），and hematoma were correlated，among which the effect of systolic blood pressure on hematoma volume at admission was statistically significant （P<0.05）. There were statistically significant differences between the groups with good and poor prognoses in terms of hematoma volume at admission，brain hernia，HCT at admission，and Glasgow Coma Scale （GCS） score （all P<0.05）. Multivariate logistic regression showed that admission GCS score and admission HCT may be independent risk factors affecting patient prognosis （all P<0.05）. Conclusion The volume of intracerebral hemorrhage at 4500 m altitude may be related to systolic blood pressure，hemoglobin，and HCT at admission，and systolic blood pressure at admission has a positive impact on the hematoma volume. GCS score and HCT at admission may affect patient prognosis.
Key words: ultrahigh altitude area, intracerebral hemorrhage, prognosis, influencing factor
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