To explore the influencing factors of hematoma enlargement in spontaneous cerebral hemorrhage and analyze the relationship with prognosis.

From December 2013 to December 2018, 670 patients with spontaneous intracerebral hemorrhage were selected from the Department of Brain Surgery, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine. According to the reexamination of CT within 72 h, they were divided into hematoma expansion group (77 cases) and hematoma stabilization group (593 cases). The clinical data of the two groups were recorded, the influencing factors of hematoma expansion were analyzed, followed up for 3 months after discharge, and the prognosis of the two groups was compared.

Among 670 patients, hematoma enlargement occurred in 77 cases, the incidence was 11.49% (77/670), of which 45 had poor prognosis, 32 had good prognosis, 593 had stable hematoma group, 261 had poor prognosis, 332 had good prognosis, the difference between the two groups was statistically significant (P<0.05). Single factor analysis showed that there were significant differences in activated partial thromboplastin time, volume of first CT hematoma, shape of hematoma, history of hypertension and stroke between hematoma expansion group and hematoma stabilization group (P<0.05). Multivariate analysis showed that hypertension, history of stroke and shape of hematoma were independent risk factors for hematoma enlargement of spontaneous cerebral hemorrhage (OR>1, P<0.05).

The independent risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage include hypertension, stroke history and irregular hematoma shape.Hematoma enlargement can increase the adverse prognosis.