目的 探讨影响经外侧裂入路治疗青年人基底节区高血压脑出血预后的危险因素。方法 选择2006年1月至2019年6月在我院接受外侧裂入路治疗的青年基底节区高血压性脑出血患者资料进行回顾性分析,收集患者年龄、性别、体质量指数、血压、出血量、术前GCS、合并症等临床资料,观察与临床预后的相关性。结果 单因素分析显示,性别、糖尿病与患者的预后不良无相关性(P＞0.05),年龄、体质量指数、GCS评分、出血量、血肿破入脑室、手术时机、高血压病史、合并脑疝、最高收缩压与预后不良具有相关性(P＜0.05)。多因素二分类Logistic分析结果显示,出血量≥50mL、脑疝、手术时机是导致患者预后不良的独立危险因素(P＜0.05),GCS评分是预后不良的保护性因素(P＜0.05)。结论 经外侧裂入路治疗青年人基底节区高血压脑出血的预后受多种因素综合影响,应引起临床重视。

Objective To study the risk factors for prognosis of young patients with hypertensive intracerebral hemorrhage in basal ganglia treated by lateral fissure approach. Methods The data of young patients with hypertensive cerebral hemorrhage in basal ganglia treated by lateral approach in our hospital from January 2006 to June 2019 were retrospectively analyzed.The clinical data of age, sex, body mass index, blood pressure, bleeding volume, preoperative GCS and complications were collected to observe the correlation with clinical prognosis. Results The univariate analysis showed that gender and diabetes were not correlated with poor prognosis (P > 0.05), and the age, body mass index, GCS score, bleeding volume, hematoma rupture into ventricle, timing of operation, history of hypertension, cerebral hernia, maximum systolic pressure were correlated with poor prognosis (P < 0.05). The multivariate binary logistic analysis showed that bleeding volume (> 50 mL), cerebral hernia and timing of operation were independent risk factors for poor prognosis (P < 0.05), and GCS score was a protective factor for poor prognosis (P < 0.05). Conclusion The prognosis of young patients with hypertensive cerebral hemorrhage in basal ganglia treated by lateral fissure approach is affected by many factors, which should be paid attention to clinically.