dic评分在高血压脑出血继续出血研究中的临床应用.docVIP

DIC评分在高血压脑出血继续出血研究中的临床应用 江西省新余市人民医院神经外科 胡志斌 龙敏 江西省新余市罗坊医院 胡金香 摘要：目的 了解DIC评分与高血压脑出血急性期出血情况变化及其预后的关系。方法 测定并记录416例高血压脑出血急性期入院时DIC评分、及GCS评分、1个月后GOS评分；按照DIC评分分为0分、1分、2分、3分、≥4分共五组, 根据患者病情及头颅CT变化将患者分为血肿扩大组（149例）和血肿稳定组（267例）。采用SPSS12.0统计软件对资料进行统计分析。结果 通过研究发生，血肿稳定组绝大部分DIC分值在3分以下而血肿扩大组DIC评分大部分在3分以上，DIC评分越高，继续出血的可能性越大，预后越差。结论 DIC评分是评估高血压脑出血急性期出血情况变化及其预后的可靠指标。 关键词：高血压脑出血继续出血 DIC评分 预后 Abstract: Objective—To understand relations between DIC scoring and hemorrhage changes in acute phases of hypertensive cerebral hemorrhage＆prognosis. Methods—To measure and record DIC scores and GCS scores for 416 acute-phase patients with hypertensive cerebral hemorrhage when they were hospitalized and their GOS scores one month later; based on DIC scores we get five groups—Group for those with 0 score, Group for those with 1 score, Group for those with 2 scores, Group for those with 3 scores and Group for those with 4 or more scores; based on patients’ conditions and their heads’ CT changes, we classify them into Group (149 patients) with expanded hematoma and Group (267 patients) with stable hematoma. We conduct statistical analyses on data obtained by using SPSS12.0 statistical software. Results—Our studies show that most of DIC scores for Group with stable hematoma are below 3 while those for Group with expanded hematoma are above 3, namely the higher DIC scores are, the more likely for patients to have continuous hemorrhage and the worse prognosis turns to be. Conclusion—DIC scoring is a reliable index in evaluating hemorrhage changes in acute phases of hypertensive cerebral hemorrhage and prognosis. Key words: hypertensive cerebral hemorrhage; continuous hemorrhage; DIC scoring; prognosis. 高血压脑出血是脑卒中最严重的一种类型，急性期病死率可能与脑出血继续出血有关，继续出血使血肿进一步增大，导致临床症状的进行性恶化甚至死亡，脑血管破裂一旦出血即原有的凝血、抗凝及纤溶之间的平衡被打破，机体将产生一系列的病理生理改变，DIC评分是评估凝血状态的综合指标，分值高低可反映凝血障碍的严重情况，我们于2007年3月份开始应用计算DIC分值来分析其与高血压脑出血急性期出血情况变化的关系，有助于防治血肿扩大而达到改善脑出血患者预后的效果。 1、资料与方法 1.1病例选择：收集2007年3月1日至2013年3月1日高血压脑出血住院患者416例。入选标准：①符合全国