目的研究复发性脑出血的临床特征及预后,并提出相应的预防措施。方法对2010年1月~2013年10月住院治疗的复发性脑出血患者的危险因素、复发间隔时间、服药情况等资料进行分析,并对幸存患者进行电话随访。结果调查脑出血患者共1800例,其中复发性脑出血患者367例,有高血压病病史201例;第1次出血到第2次出血时间以1年内复发率最高;复发时间最短1个月,最长达20年。再出血发生于对侧200例,同侧74例,病人未规律服药是诱发再出血的重要因素之一,服用抗血小板聚集药物后脑出血的复发率及死亡率比未服用抗血小板聚集药物的患者明显升高(P<0.05)。电话随访复发性脑出血367例,其中有67例因电话停机、空号等因素不能接通,12例接通后拒绝进一步回答并挂断电话,12例诉“电话打错了”。其余274例患者,经电话随访得知已有50例去世,45例日常生活不能自理,130例生活可自理,49例不详。结论复发性脑出血病灶大多在首发病灶的对侧,病死率、致残率高,且再发与高血压关系密切,任何可能引起血压剧烈波动的原因都可能导致脑出血的再发,因此控制血压是防止复发性脑出血发生的关键,而提高患者的服药依从性至关重要,服用抗血小板聚集药物的获益与风险仍待进一步研究与探索。大多数患者生活态度乐观并坚持康复锻炼,肢体功能恢复良好,有一部分患者因再次出血后出现抑郁等不良情绪,对其终点事件(死亡)起到了推动作用;主要死因为脑疝形成、上消化道出血、肺部感染及心力衰竭。 Objective To study the clinical characteristics and prognosis of recurrent intracerebral hemorrhage and to propose corresponding preventive measures. Methods From January 2010 to October 2013, the risk factors, relapse interval and medication were analyzed in hospitalized patients with recurrent cerebral hemorrhage. Survival patients were followed up by phone. Results A total of 1800 cases of patients with intracerebral hemorrhage were investigated. Among them, 367 patients had recurrent cerebral hemorrhage and 201 patients had a history of hypertension. The time from the first bleeding to the second hemorrhage was the highest in one year. The shortest recurrence time was 1 month, Up to 20 years. Rebleeding occurred in the contralateral 200 cases, ipsilateral 74 cases, the patient is not regularly taking medication is one of the important factors in inducing hemorrhage. After taking anti-platelet aggregation drug, the recurrence rate and mortality rate of cerebral hemorrhage than those who did not take anti-platelet aggregation drug Was significantly higher (P <0.05). Telephone follow-up of 367 cases of recurrent intracerebral hemorrhage, of which 67 cases due to phone down, empty number and other factors can not be connected, 12 refused to answer further after the call and hang up, 12 cases “Phone wrong ”. The remaining 274 patients, 50 cases by telephone follow-up was reported that 45 cases of daily life can not take care of themselves, 130 cases of life can take care of themselves, 49 cases are unknown. Conclusion Most of the recurrent cerebral hemorrhage lesions are contralateral to the first lesion with high mortality and morbidity. The recurrence and hypertension are closely related. Any reason that may lead to severe fluctuations in blood pressure may lead to recurrence of cerebral hemorrhage, so control Blood pressure is to prevent the occurrence of recurrent intracerebral hemorrhage is the key, and to improve patient compliance is essential, taking anti-platelet aggregation benefit and risk remains to be further studied and explored. Most patients were optimistic about their life attitude and insisted on rehabilitation exercise. Their body functions recovered well. Some patients had some negative emotions such as depression after bleeding again, which promoted their end point (death). The main causes of death were hernia formation, upper digestion Road bleeding, pulmonary infection and heart failure.