目的 研究脑出血迟发性脑水肿与纤维蛋白原(FIB)等因素的相互联系,并探讨对脑出血预后的影响.方法 回顾性分析本院2008年1月～2011年2月接受内科保守治疗的非外伤性急性脑出血60例,其中并发迟发性脑水肿29例,未发生迟发性脑水肿31例.于发病后连续3周监测FIB值等指标,并同时期行头颅CT检查,动态观察血肿及其周围水肿的变化.行χ2检验比较迟发性脑水肿组与未发生组间FIB的升高率; logistic回归分析迟发性脑水肿与各指标的相关性,并采用多元逐步COX模型分析脑出血预后的相关影响因素.结果 迟发性脑水肿组较未发生组FIB值明显升高(P＜0.005); FIB升高、脑出血量大、吸烟、高血压病史与迟发性脑水肿相关(P<0.05);迟发性脑水肿、持续升高的FIB和高血压病影响脑出血的预后,其P值均<0.05,有统计学意义.结论 脑出血者FIB持续升高、脑出血量大、吸烟、高血压与迟发性脑水肿的发生密切相关,迟发性脑水肿、FIB升高和高血压病影响预后,对疾病恢复有不良影响.%Objective To observe Pibrinogen and other related factors on delayed cerebral edema in cerebral hemorrhage, and to explore related factor impact on prognosis in cerebral hemorrhage. Methods Analyzed retrospectively the 60 cases of acute non-traumatic and conservative treated cerebral hemorrhage in January 2008- February 2011, which 29 cases complicated with delayed cerebral edema and 31 cases not complicated . Monitored FIB values and other indicators for three weeks ,and observed hematoma and the surrounding low-density changes by head CT during the same period; x2 test to compare the increase rate of FIB in two groups; Analyze related factors on delayed cerebral edema and their relationship with prognosis. Results FIB significantly increased in delayed brain edema group(P＜0. 005). Elevated FIB, hematoma volume, smoking, and hypertension associated with delayed cerebral edema(P＜0. 05). Delayed cerebral edema, elevated FIB and hypertension influenced the prognosis (ever P＜0. 05). Conclusions FIB, hematoma volume, smoking, and hypertension closely associated with delayed cerebral edema. Delayed cerebral edema, persistent elevated FIB, hypertension influenced the prognosis, and have an adverse effect on the disease recovery.
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