2019•国际医药卫生导报Requires access
Risk factors of rebleeding after surgery for hypertensive intracerebral hemorrhage and its countermeasures
Wu-feng Luo, Yingbiao Hong, Jiebo Cai, Chen Ze-xin, Yuehao Cai, Guangjun Huang
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Abstract
Objective
To discuss the coherent risk indicators of re-bleeding after the first operation for cerebral hemorrhage caused by spontaneous vascular hypertension, and to reduce the risk of rebleeding taking some countermeasures corresponding to the relevant risk factors.
Methods
130 patients with cerebral hemorrhage caused by spontaneous vascular hypertension treated at the department of neurology of our hospital were randomly selected as study objects, and were surgically treated and divided into a rebleeding group and a control group. The clinical data of the two groups were compared. The risk factors of rebleeding on the first operation sites were analyzed.
Results
The incidence of rebleeding on surgical sites after the first operation due to various factors was 9.23%. The head CT scan showed that the rebleeding sites were located in the original surgical area, and the mortality of rebleeding patients reached 59.68%. In patients with spontaneous angiogenic hypertensive intracerebral hemorrhage, postoperative local rebleeding positively correlated with the first operation time after hemorrhage, coagulation factor loss or poor coagulopathy, postoperative mean value of systolic blood pressure detected by NICU or ICU, and the degree of postoperative agitation (all P 0.05). Logistic regression equation was used to analyze all possible related risk factors, and the results showed that the coagulation dysfunction caused by acute onset to first surgery intervention, clotting factor loss or poor, and the mean postoperative systolic blood pressure detected by NICU were the independent risk factors for postoperative rebleeding on the surgical sites (all P<0.05).
Conclusion
Mastering the time of initial surgery after cerebral hemorrhage, good management of postoperative blood pressure, correcting possible coagulopathy, and avoiding postoperative irritability can significantly reduce the chance of recurrent bleeding after initial surgery for spontaneously hypertensive cerebral hemorrhage.
Key words:
Hypertensive cerebral hemorrhage; Rebleeding; Risk factors; Countermeasures