Related Factors That Influence Death Of Patients With Hypertensive Intracerebral Hemorrage Shortly After Surgery

Objective: To search for the related factors that influence death of patients with hypertensive intracerebral hemorrage shortly after surgery. Methods: 126 patients attacked with HICH for the first time were retrospectively analyzed as clinical group. The following factors were analyzed: age, blood pressure when attack occurred, hemorrage site, hemorrage volume, conscious state, blood sugar, leukocyte account, surgery chance, surgery style and complication. 28 surgery patients with HICH were prospectively analyzed as analyzing group by determining serum LDH, CRP. Blood samples were obtained through phlebotomizing 3 days, 7 days and 30 days before surgery respectively. Results: There were 126 patients in clinical group, 99 patients survived within one month after the attack, and 27 patients died,with a death rate of 27.3%. The analysis showed that following factors were significantly related to death shortly after surgery (P<0.01): GCS score, MAP, hemorrage volume, encephalothlipsis, body temperature>39℃within 3 days after attack, WBC>20x 10¹²/L,blood sugar I>10mmol/L, shaped ventricle by hematoma, coronary heart disease, liver and kidney disease, diabetes complication, disappearance or not of cycle pool in CT image or midline shift>lcm. Blood pressure^>200/110mmHG after attack within 3 days has very remarkable significance to death and hemorrhage rate after surgery (P<0.01). significant difference was shown with whether blood pressure > 180/100mmHg or not within 3 day after attack, thalamus hemorrhage, surgery style (P<0.05). No significant difference was seen with body temjferature<39℃, WBC< 20 x 10¹²/L, blood sugar<10mmol/L, blood breaking into ventricle, surgery chance, hemorrhage again after surgery and complication after surgery. 28 patients were in analysis group, with 2 deaths in 3 days, 3 deaths within 3 to 7 days, 2 patients abandoning treatment within 7 to 30 days (counting as death), with the death rate as 25%. The changes of LDH and CRP were highest short after the onset of attack, dropping slowly as days went by and finally reached normal level in more than 30 days. As to hemorrhage sites,serum LDH and CRP level were highest when hemorrhage occurred in thalamus or blood breaking into ventricle (P<0.01); Serum level of LDH and CRP in patients who finally died were significantly higher than those in survival patients (P<0.01). Conclusion: The related factors of patients with HICH are GCS score, hemorrhage volume, encephalothlipsis, MAP when admitted. Body temperature>39°C WBC>20 x 1012/L. blood sugar> 10mmol/L,shaped ventricle by hematoma, coronary heart disease, liver and kidney disease, disappearance or not of cycle pool in CT image or midline shift are all highly associated to the death rate. Blood pressure>200/110mmHg 3 day after surgery has highly remarkable relation to death or hemorrhage rate. There is only slightly relation between death rate and age and surgery style. No relation is found with gender, body...