Clinic Analysis Of Continuous Hemorrhage After Intracerebral Hemorrhage

Object:Continuous hemorrhage after intracerebral hemorrhage is a major cause of clinical deterioration. Identification of fac tors that predispose to continuous hemorrhage is very impor tant in managing patients.We undertook this study to deter mine, through the statistical analyses, the dangerous factors of continuous hemorrhage after intraerebral hemorrhage occurring after admission, the clinical and prognosis feature.Methods:We selected 313 patients with ICH admitted within 24 hours of onset. The first CT was performed at admission and the second at the time of worse. According to the CT result ,we separated objective group (with continuous hemorrhage) and contrast group (without continuous hemorr-hage). Statistical analyses were performed to assess the relationships between continuous hemorrhage and BP, the moving history, the fature of the CT, the using of Mannitol. At the same time, we investigated the clinical and prognosis fature.Result:1. SBP, DBP, MAP and pulse pressure of continuous hemorrhage group were significantly higher than the non-continuous hemorrhage group (P<0.05). Whose SBP>200mmHg and DBP>110mmHg of continuous hemorrhage group were more than non-continuous hemorrhage group, the difference was significant (P<0.01).2. Patients with early using of mannitol of continuous hemorrhage group was significantly more than that of non-continuous hemorrhage group (P<0.01).3. Thalamic hemorrhage of continuous hemorrhage group was significantly more than non-continuous hemorrhage group (P<0.05). The volume of bleeding of continuous hemorrhage group was significantly higher than the non-continuous hemorrhage group (P<0.05). The ratio of bleeding volume>20 ml was significantly higher than non-continuous hemorrhage group (P<0.01). Hematoma with irregular shape and cerebral hemorrhage broken into ventricle were more prone to continuous hemorrhage (P<0.01).4. The moving history of continue hemorrhage group was significantly higher than that of non-continuous hemorrhage group (P<0.01).5. Patients with deeper disturbance of consciousness of continuous hemorrhage were the most common (P<0.05). And the BT was increased significantly (P<0.05), especially in the range 37.3-38℃(P<0.05).6. The proportion of significant progress, progress and unchanged of continuous hemorrhage group were significantly lower and the deterioration and mortality rates were significantly higher than non- continuous hemorrhage group (P<0.01). Conclusion:1. Continuous hemorrhage after cerebral hemorrhage was closely related to a variety of factors.2. High blood pressure was one of the risk factors to continue hemorrhage, SBP>200mmHg and DBP>110mmHg were more prone to continuous hemorrhage.3. Using mannitol Early (within 6h) was more prone to continuous bleeding.4. Thalamic hemorrhage, bleeding of more than 20 ml, hematoma with irregular shape or hemorrhage broken into ventricle were more prone to continuous hemorrhage.5. Early onset existing long-distance transport, dramatic move or activity, irritability, vomiting and convulsions, and other violent situations were more prone to continuous hemorrhage.6. Patients with continuous hemorrhage mainly manifestated increasing awareness obstacles, but also limb paralysis, speech dysfunction, cranial nerve symptoms worse relatively rare. The BT was increased significantly.7. The deterioration and mortality rates of the patients with continuous hemorrhage were significantly increased, the prognosis was poor.