Logistic regression analysis of risk factors in hematoma enlargement in hypertensive intracerebral hematoma after surgical clot evacuation

徐伦山; 周椿; 许民辉; 陈广鑫

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Logistic regression analysis of risk factors in hematoma enlargement in hypertensive intracerebral hematoma after surgical clot evacuation

更新时间：2026-01-09

- Logistic regression analysis of risk factors in hematoma enlargement in hypertensive intracerebral hematoma after surgical clot evacuation
- Journal of Army Medical University Vol. 31, Issue 16, Pages: 1596-1598(2009)
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  CLC： R195.4;R544.106;R743.340.5
- Published：2009
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徐伦山,周椿,许民辉,陈广鑫.高血压脑出血术后血肿扩大的Logistic回归分析[J].陆军军医大学学报(原第三军医大学学报),2009,31(16):1596-1598.

　XU Lun-shan,ZHOU Chun,XU Min-hui,CHEN Guang-xin.Logistic regression analysis of risk factors in hematoma enlargement in hypertensive intracerebral hematoma after surgical clot evacuation[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(16):1596-1598.
徐伦山,周椿,许民辉,陈广鑫.高血压脑出血术后血肿扩大的Logistic回归分析[J].陆军军医大学学报(原第三军医大学学报),2009,31(16):1596-1598. DOI：

　XU Lun-shan,ZHOU Chun,XU Min-hui,CHEN Guang-xin.Logistic regression analysis of risk factors in hematoma enlargement in hypertensive intracerebral hematoma after surgical clot evacuation[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(16):1596-1598. DOI：

摘要

目的探讨高血压脑出血（hypertensive intracerebral hematoma， HICH）术后血肿扩大可能的危险因素，指导临床治疗，防止血肿扩大，降低致残率和病死率。方法回顾性分析本院2006年1月至2008年1月住院的发病后24 h内手术治疗的47例高血压脑出血患者的临床资料，其中术后血肿扩大10例，分析术后血肿扩大的相关因素，包括年龄、性别、糖尿病、收缩压水平、潜在凝血功能障碍疾病、肝脏疾病、脑卒中病史、抗高血压药物治疗、HICH发生至开始手术时间、血浆纤维蛋白原水平、术中止血效果验证等。结果在血肿扩大组中有几种倾向：年轻化，肝脏疾病者，发病至手术间隔时间短，以及止血不彻底，但多因素Logistic回归分析提示术中止血效果确认可预防术后血肿扩大。结论术中止血效果确认未能彻底止血者是高血压脑出血术后血肿扩大的预测因素，必须尽力做到术中止血。

Abstract

Objective To elucidate predisposing factors for enlargement of hypertensive intracerebral hematoma (HICH) after craniotomy and dot evacuation for the prevention of hematoma enlargement and the reduction of morbidity and mortality. Methods Records of 47 patients undergoing craniotomy and clot evacuation within 24 h after onset from Jan 2006 to Jan 2008 were analyzed retrospectively. Postoperative hematoma enlargement was found in 10 patients. The predisposing factors inclusive of age

gender

diabetes mellitus

systolic blood pressure

underlying diseases for anticoagulation

liver diseases

history of brain hemorrhage or stroke

antihypertension medication

duration from HICH onset to commencement of operation

serum plasma fibrinogen level at the time of admission

and hemostasis during operation. Results Mono-agent logistic analysis showed a significant correlation between hemotoma enlargement with age

liver diseases

duration from HICH onset to commencement of operation

and difficult thorough hemostasis during operation (P0.05). Multivariate analysis with a logistic regression model showed a thorough hemostasis during operation could prevent HICH enlargement (OR 0.069

95%CI 0.006-0.789

P=0.031). Conclusion Thorough hemostasis during the operation is an important predisposing factor for HICH enlargement or recurrent hemorrhage.

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