Study On The Prognosis Of Supratentorial Hypertensive Intracerebral Hemorrhage

Objective To discuss the influencing factors of supratentorial hypertensive intracerebral hemorrhage, and to compare their influence to the prognosis of SICH.Methods Retrospective analyzed the 324 consecutive cases with SICH admitted in Department of Neurosurgery, Second Affiliated Hospital, Chong Qing University of Medical Science, from January 2001 to January 2006, with general data, symptoms onset, signs on admission, imageological data, therapy strategies and complications as independent variables, and FIM after 1 month as dependent variable. Grouped measurement data used t-test and F-test, continuous mea- surement data used linear correlation analysis, screened the influencing factors of prognosis of SICH, then the valuable influencing factors were filtrated and formulated with multiple regression analysis model and their contribution were compared.Results1. The factors with significant influence to the prognosis were screened out with t-test,F-test and linear correlation analysis. These factors include disease history of respiratory system, onset time, vomit, disorder of limbs activity, conscious disturbance, urinary and fecal incontinence, systolic pressure on admission, diastolic pressure on admission, mean arterial pressure on admission, GCS on admission, pupillary diameter, grade of pupillary light reflex, grade of limbs muscle force, pathological reflexes, neck rigidity, side of haematoma, location of haematoma, brain hernia, volume of haematoma, haematoma enlargement, augmented volume after haematoma enlargement, ventricular blood whether or not and its volume, ventricular casting mould, acute hydrocephalus, midline shift on CT scan, blood glucose on admission, leucocyte count on admission, completely medical treatment, incision of trachea, pulmonary infection, stress ulcer, alimentary infection.2. Multiple regression analysis by forward stepwise were performed. The equation is as follows Y? =-0.085X1+0.216X2-0.235X3- 0.368X4- 0.093X5-0.113X6-0.173X7 , P<0.05, Y? is dependent variable, X1-7 are independent variables which represent systolic pressure on admission, GCS on admission, ventricular blood whether or not, volume of haematoma, stress ulcer, haematoma enlargement, pulmonary infection; the coefficient of X is standardized partial regression coefficient. The absolute value of the standardized partial regression coefficient in the equation denote the difference of such factors'influence to the prognosis of SICH.Conclusion It is suggested that volume of haematoma, GCS on admission, ventricular blood whether or not, pulmonary infection ,haematoma enlargement, stress ulcer, systolic pressure on admission are the critical predicted index of prognosis of SICH, and we should pay attention and strengthen the treatment, control and prevention to them in clinic.