Abstract: Objective To explore the related risk factors of postoperative cerebral infarction in patients with hypertensive cerebral hemorrhage. Methods A total of 78 patients with hypertensive cerebral hemorrhage who were treated by surgery in our hospital from November 2018 to November 2023were selected,and the risk factors of 20 patients with postoperative cerebral infarction were analyzed by single factor,and the statistically significant high-risk factors were screened for Logistic regression analysis. Results Univariate analysis showed that gender,age,smoking,drinking,history of cerebral infarction,bleeding site,bleeding volume,pupil size,GCS score and surgical methods were not risk factors for postoperative cerebral infarction in patients with hypertensive cerebral hemorrhage (P＞0.05);however,the duration of hypertension≥20 years,brain herniation,midline shift ≥5 mm and intraoperative hypotension were the risk factors,and the difference was statistically significant (P＜0.05).Logistic regression analysis showed that intraoperative hypotension was its independent riskfactor,the difference was statistically significant (P＜0.05). Conclusion The duration of hypertension≥20 years,brain herniation,midline shift≥5 mm and intraoperative hypotension are risk factors for postoperative cerebral infarction in patients with hypertensive intracerebral hemorrhage.Intraoperative hypotension is an independent risk factor,and intraoperative blood pressure should be well controlled,and patients with high risk factors should be treated to prevent cerebral infarction.

Key words: Hypertensive intracerebral hemorrhage, Cerebral infarction, Risk factors

摘要： 目的 探讨高血压脑出血患者术后并发脑梗死的相关危险因素。方法 选取我院2018年11月至2023年11月收治的78例高血压脑出血行手术治疗的患者,并对20例术后出现脑梗死患者的危险因素进行单因素分析,筛选出具有统计学意义的高危因素进行Logistic回归分析。结果 单因素分析显示性别、年龄、吸烟、饮酒、既往脑梗病史、出血部位、出血量、瞳孔大小、GCS评分和手术方式不是高血压脑出血患者术后并发脑梗死的危险因素(P＞0.05),而高血压病程≥20年、脑疝、中线移位≥5 mm和术中低血压是其危险因素,差异有统计学意义(P＜0.05);Logistic回归分析显示术中低血压是其独立危险因素,差异有统计学意义(P＜0.05)。结论 高血压病程≥20年、脑疝、中线移位≥5 mm和术中低血压是高血压脑出血患者术后并发脑梗死的危险因素,术中低血压是其独立危险因素,应控制好患者术中血压,并对有高危因素的患者进行预防脑梗死的治疗。

关键词: 高血压脑出血, 脑梗死, 危险因素