A Clinical Analysis Of Antithrombotic-associated Intracerebral Hemorrhage

Objective:Analyze the clinical characteristics of antithrombotic-associated intracerebral hemorrhage,explore the influence of different treatment methods on the clinical prognosis of antithrombotic-associated intracerebral hemorrhage.Methods:All patients with ICH admitted to the neurosurgery department of our hospital on January 1,2018 and February 1,2020 were retrospectively collected.A total of 122 patients with ATT-ICH and a total of 80 patients without ATT-ICH were included.Basic clinical information of the patients was collected,analyzing the impact of epidemiology and clinical characteristics.And the effects of different intervention treatments on the prognosis of ATT-ICH were analyzed.Results:A total of 202 patients were included in the study,including 122 patients of ATT-ICH,80 patients of none ATT-ICH.In the 122 patients of ATT-ICH,including 81 males and 41 females,with an average age of69.5±10.2 years.Hemorrhage parts: brain lobe 30 cases,4 cases brokeninto the ventricle(13.3%);deep hemorrhage 58 cases,24 cases broken into the ventricle(41.4%);lobes and deep hemorrhage 7 cases,4 cases broken into the ventricle(57.1%);small cerebral hemorrhage 8 cases,4 cases broken into the ventricle(50%);others 19 cases.Reasons for drugs:prevention of cerebral infarction,atrial fibrillation and coronary heart disease 94 cases(77.0%).Initial symptoms: dizziness 13 cases,intracranial hypertension 17 cases,facial focal symptoms 12 cases,limbs focal symptoms 46 cases,syncope 7 cases,coma 20 cases,progressive consciousness disorder 5 cases,epilepsy 1 case,asymptomatic 1 case.Compared with the additional 80 cases of non-antithrombotic associated ICH patients,the mean age of the ATT-ICH patients was higher,the amount of intracerebral hemorrhage was larger,the INR value was higher,and the GOS prognosis score was lower(all of them P<0.05).Analyze the influencing factors of GOS with Ordered logistic regression,GCS is important in prognosis(b=0.748,P<0.05),time of using antithrombotic drugs,INR,amount of cerebral hemorrhage,type of antithrombotic drugs,therapy methods,hypertension,diabetes,smoking and alcohol consumption affected not significantly(all of them P>0.05).In terms of treatment,for ATT-ICH patients with mild GCS(13-15),conservative treatment have shorter hospital stays(P<0.05),but there was no significant difference in GOS(P>0.05).During moderate and severe GCS(3-12),surgical treatment had higher GOS score(P<0.05),and there was no significant difference in length of hospital stay compared to conservative treatment(P>0.05).Conclusion : Clinical symptoms of ATT-ICH are varied,with highpossibility of severe symptoms.Location of hemorrhage was uncertain,but it was mostly in the deep part and the lobe of the brain,and it had a higher rate of broken into the ventricle.Compared with the non-antithrombotic associated ICH,the mean age of the ATT-ICH patients was higher,the amount of intracerebral hemorrhage was larger,and the prognosis score was lower.The prognosis of treatment is greatly affected by the degree of illness at admission,for the moderate or severe illness at admission,surgical treatment has a better prognosis.So choice of treatment should weigh the advantages and disadvantages according to the condition at admission.