Clinical Multi-factors Analysis On Recurrent Hemorrhage Of Postoperative Hypertensive Intracerebral Hemorrhage In34Patients

Objective:To investigate the relevant factors of recurrent hemorrhage of postoperative hypertensive intracerebral hemorrhage and study the relationship between them to supply theoretic bases on prevention of postoperative recurrent hemorrhage.Methods:We retrospectively analyzed269cases of hypertensive intracerebral hemorrhage operated from Jan2007to Jan2011in Zibo central hospital. Of them, there were34cases of postoperative recurrent hemorrhage.15possible relevant factors were gathered to select the high risk ones by multiple-factor Logistic regression analysis.Results:There were156males and113females, the age ranged from36to93yrs (mean58.6±11.4yrs),124cases were older than60yrs. All cases had history of hypertension,93had diabetes,49had abnormal clotting mechanism. Hemorrhage volume was more than60ml in153cases,30ml-60ml in116cases.136cases were operated within6hours. Systolic pressure (SP) was lower than200mmHg in184cases, diastolic pressure (DP) was lower than120mmHg in215cases.83cases got craniotomy to bone disc decompression,186cases got small bone flap craniotomy or the skull minimally invasive drainage borehole.92cases hemorrhage was cleared completely.93cases had cerebral herniation before operation.105cases got fidgety.72cases took Asprin before hemorrhage. The position of hemorrhage located at basal ganglia in125cases,144cases at brain parenchyma and thalamus.34cases hemorrhaged again after operation(12.6%,34/269) and14cases died(41.1%,14/34). Single factor analysis showed that admission DP>120mmHg and SP>200mmHg were closely relevant to recurrent hemorrhage of postoperative hypertensive intracerebral hemorrhage (P<0.01). And the time from intracerebral hemorrhage to operation<6hours, abnormal clotting mechanism and the mode of craniotomy to bone disc decompression were relevant to recurrent hemorrhage of postoperative hypertensive intracerebral hemorrhage (P<0.05). While multiple-factor Logistic regression analysis found4more meaningful relevant variables including admission DP>120mmHg, admission SP>200mmHg, the time from intracerebral hemorrhage to therapy<6hours and abnormal clotting mechanism (P<0.05).Conclusion:1.Admission DP>120mmHg and admission SP>200mmHg were the main relevant factors with recurrent hemorrhage of postoperative hypertensive intracerebral hemorrhage.2.Super-early operation and abnormal clotting mechanism were relevant to recurrent hemorrhage of postoperative hypertensive intracerebral hemorrhage.