The Effect Of Stress-induced Hyperglycemia On Postoperative Intracerebral Hemorrhage And Risk Factors Affecting Its Prognosis

Objective: To explore the impact of stress hyperglycemia on the prognosis of patients undergoing craniotomy after intracerebral hemorrhage and analyze the risk factors that affect their prognosis.Methods: The data of patients who underwent craniotomy after intracerebral hemorrhage were analyzed retrospectively.According to whether stress hyperglycemia occurred after intracerebral hemorrhage,they were divided into stress hyperglycemia group and non-stress hyperglycemia group,among which stress hyperglycemia group 96 cases,83 cases in the nonstress hyperglycemia group,compare the clinical baseline data,postoperative related conditions and complications,prognosis and follow-up of the two groups,and then group them according to the clinical prognosis and survival 3 months after surgery.Multivariate regression analysis of the risk factors affecting the poor prognosis of cerebral hemorrhage and craniotomy hematoma removal.Results: Compared with the non-stress-induced hyperglycemia group,the patients in the stress-induced hyperglycemia group accounted for a higher proportion of the total length of stay in the ICU after surgery,the risk of postoperative rebleeding was higher,the intracranial infection rate was higher,and the risk of stress ulcers was higher(P<0.05),while the pulmonary infection rate was not statistically significant between the two groups(P>0.05).Patients in the stress hyperglycemia group had higher mortality in 3 months after surgery,and GOS prognosis score in 3 months was lower,the ratio of GOS≥4 points was lower,the KPS score in January and June was lower,and the ratio of 60 points or more was lower(P<0.05),multivariate analysis shows stress hyperglycemia,bleeding volume,GCS ≤ 8 points,postoperative rebleeding and pulmonary infection are clinical risk factors for poor prognosis after intracerebral hemorrhage and craniotomy(P<0.05).Bleeding volume,GCS≤8 points,postoperative rebleeding and intracranial infection are the clinical risk factors for death 3months after intracerebral hemorrhage,craniotomy and hematoma removal(P<0.05).Conclusion: Stress hyperglycemia is related to the proportion of ICU stay in patients with cerebral hemorrhage and craniotomy to the total hospital stay,postoperative rebleeding,intracranial infection,stress ulcer,and prognosis score.Stress hyperglycemia,bleeding volume,GCS≤8 points,postoperative rebleeding,and pulmonary infection are clinical risk factors for poor prognosis after cerebral hemorrhage after craniotomy.Bleeding volume,GCS≤8 points,postoperative rebleeding,intracranial infection are clinical risk factors for death 3 months after cerebral hemorrhage and craniotomy.