Objective To investigate the relationship between the bowel gas patency and recent clinical out-comes in patients with acute cerebral hemorrhage. Methods Consecutive patients with spontaneous intracerebral hemorrhage admitted within 24h after onset were prospectively included. A unified data collection form was formu-lated to collect demographic information data (age, gender), vascular risk factors (hypertension, diabetes, hyperlipi-demia, smoking, drinking), admission clinical neurological deficit score according to the U.S. National Institutes of Health Stroke Scale(NIHSS), radiology information(hematoma location, hematoma volume), the test results of labo-ratory (white blood cell count, blood glucose, blood lipids, C-reactive protein), the first defecation time after the occurrence of the disease and defecation frequency in 2 weeks. Modified Rankin Scale(mRS) was used to evaluate the clinical outcome in a month. The patients were divided into a good outcome group (mRS≤2) and a poor out-come group (mRS≥3). Results A total of 113 patients with acute cerebral hemorrhage were included, with 68 patients(60.2%) in poor outcome group and 45 patients(39.8%) in good outcome group. Univariate analysis showed that the hematoma volume(26.67±7.94cm3 vs 22.86±7.42cm3; t=2.542, P=0.012), the NIHSS(20.18±6.95 vs 16.02± 6.62; t=3.17, P=0.002), white blood cell count [(10.28±3.06)×109 vs (8.91±2.88)×109; t=2.379, P=0.019], fasting glucose(8.45±1.73mmol/L vs 7.08±1.67mmol/L;t=4.166, P=0.000), triglycerides(2.26±0.97mmol/L vs 1.74±0.85mmol/L; t=2.929, P=0.004), C-reactive protein(11.01±6.08mg/L vs 8.89±3.75mg/L; t=2.096, P=0.038) and first defecation time(33.87±15.14h vs 24.33±8.69h; t=3.825, P=0.000) in poor outcome group was significantly higher than those in good outcome group. The number of bowel movements of poor outcome group within 2 weeks was significantly low-er than of good outcome group(7.57±3.41 times vs 10.62±2.44 times; t=-5.175, P=0.000). Multivariable logistic re-gression analysis showed that larger hematoma volume(odds ratio [OR]=1.092, 95% confidence interval [CI]: 1.002-1.189; P=0.044) and longer first defecation time (OR=1.114, 95%CI 1.008-1.221;P=0.000) were the independent predictor factors for the short-term clinical outcomes in patients with acute cerebral hemorrhage. Conclusion The length of the time interval from cerebral hemorrhage to the first defecation was one of the independent predictors for short-term clinical outcomes in patients with cerebral hemorrhage.%目的：探讨急性脑出血患者近期临床转归与腑气通畅程度的关系。方法前瞻性连续纳入发病24h内入院的自发性幕上脑出血患者。制定统一的资料收集表，收集人口统计学资料（年龄、性别）、血管危险因素（高血压、糖尿病、高脂血症、吸烟、饮酒）、入院时临床神经功能缺损评分按照美国国立卫生院卒中量表（NIHSS）、放射学资料（血肿部位、血肿体积）、实验室检查结果（白细胞计数、血糖、血脂、C-反应蛋白）、发病后第一次排便时间、2周内排便次数。发病后1个月应用改良Rankin量表（mRS）评价临床转归，以mRS评分≤2分定义为转归良好组，mRS评分≥3分定义为转归不良组。结果共纳入113例急性脑出血患者，其中转归不良组68例（60.2％），转归良好组45例（39.8％）。单变量分析显示，转归不良组与转归良好组比较，血肿体积[（26.67±7.94）cm3对（22.86±7.42）cm3；t＝2.542，P＝0.012]、NIHSS 评分[（20.18±6.95）分比（16.02±6.62）分；t＝3.17，P＝0.002]、白细胞数[（10.28±3.06）×109/L比（8.91±2.88）×109/L；t＝2.379，P＝0.019]、空腹血糖[（8.45±1.73） mmol/L比（7.08±1.67）mmol/L；t＝4.166，P＝0.000）]、甘油三酯[（2.26±0.97）mmol/L比（1.74±0.85）mmol/L；t＝2.929，P＝0.004]、C反应蛋白[（11.01±6.08）mg/L比（8.89±3.75）mg/L；t＝2.096，P＝0.038]、第一次排便时间[（33.87±15.14）h比（24.33±8.69）h；t＝3.825，P＝0.000]、2周内排便次数[（7.57±3.41）次比（10.62±2.44）次；t＝-5.175，P＝0.000]。多变量logistic回归分析显示，血肿体积较大[优势比（OR）1.092，95％可信区间（CI）1.002~1.189；P＝0.044]、第一次排便时间较长（OR 1.114，95％CI 1.008~1.221；P＝0.000）是急性脑出血患者短期临床转归的独立预测因素。结论脑出血后第一次排便时间的间隔长短是脑出血患者短期临床转归的独立预测因素之一。
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