中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2012年
5期
274-277
,共4页
黄凯滨%姬仲%吴永明%王胜男%林镇洲%潘速跃
黃凱濱%姬仲%吳永明%王勝男%林鎮洲%潘速躍
황개빈%희중%오영명%왕성남%림진주%반속약
脑桥出血,原发性%危险因素%格拉斯哥昏迷评分%出血量%多元logistic回归%受试者工作特征曲线
腦橋齣血,原髮性%危險因素%格拉斯哥昏迷評分%齣血量%多元logistic迴歸%受試者工作特徵麯線
뇌교출혈,원발성%위험인소%격랍사가혼미평분%출혈량%다원logistic회귀%수시자공작특정곡선
Primary pontine hemorrhage%Risk factor%Glasgow coma scale%Hemorrhage volume%Multivariate logistic regression%Receiver operating characteristic curve
目的 探讨影响原发性脑桥出血患者预后的危险因素.方法 回顾性分析广州市南方医院神经内科收治的60例原发性脑桥出血患者的病历资料,根据发病30d的存活情况分为存活组(34例)和死亡组(26例).分别对患者的相关临床数据和影像学特点进行单因素和多元logistic回归分析,对多元logistic回归分析结果有统计学意义的连续性变量进行受试者工作特征曲线(ROC曲线)分析,判定其截断值.结果 60例原发性脑桥出血患者30d病死率为43.3％.单因素分析结果显示,入院时格拉斯哥昏迷评分(GCS)、体温、心率、出血量、是否使用呼吸机辅助呼吸、血肿是否破入脑室、血肿部位与原发性脑桥出血患者30 d病死率有关.多元logistic回归分析显示,入院时GCS评分[优势比(OR=0.745,95％可信区间(95％CI)为(0.585,0.949)]、出血量[ OR=1.438,95％CI( 1.077,1.919)]以及血肿部位[基底-被盖型,OR=0.120,95％CI(0.016,0.904)]为影响原发性脑桥出血预后的独立危险因素(均P＜0.05).ROC曲线分析显示,入院时GCS评分及出血量的截断值分别为7.5分和5.5 ml.结论 原发性脑桥出血患者血肿位于基底-被盖部、入院时GCS评分＜7.5分、出血量≥5.5 ml者提示30 d预后不良.
目的 探討影響原髮性腦橋齣血患者預後的危險因素.方法 迴顧性分析廣州市南方醫院神經內科收治的60例原髮性腦橋齣血患者的病歷資料,根據髮病30d的存活情況分為存活組(34例)和死亡組(26例).分彆對患者的相關臨床數據和影像學特點進行單因素和多元logistic迴歸分析,對多元logistic迴歸分析結果有統計學意義的連續性變量進行受試者工作特徵麯線(ROC麯線)分析,判定其截斷值.結果 60例原髮性腦橋齣血患者30d病死率為43.3％.單因素分析結果顯示,入院時格拉斯哥昏迷評分(GCS)、體溫、心率、齣血量、是否使用呼吸機輔助呼吸、血腫是否破入腦室、血腫部位與原髮性腦橋齣血患者30 d病死率有關.多元logistic迴歸分析顯示,入院時GCS評分[優勢比(OR=0.745,95％可信區間(95％CI)為(0.585,0.949)]、齣血量[ OR=1.438,95％CI( 1.077,1.919)]以及血腫部位[基底-被蓋型,OR=0.120,95％CI(0.016,0.904)]為影響原髮性腦橋齣血預後的獨立危險因素(均P＜0.05).ROC麯線分析顯示,入院時GCS評分及齣血量的截斷值分彆為7.5分和5.5 ml.結論 原髮性腦橋齣血患者血腫位于基底-被蓋部、入院時GCS評分＜7.5分、齣血量≥5.5 ml者提示30 d預後不良.
목적 탐토영향원발성뇌교출혈환자예후적위험인소.방법 회고성분석엄주시남방의원신경내과수치적60례원발성뇌교출혈환자적병력자료,근거발병30d적존활정황분위존활조(34례)화사망조(26례).분별대환자적상관림상수거화영상학특점진행단인소화다원logistic회귀분석,대다원logistic회귀분석결과유통계학의의적련속성변량진행수시자공작특정곡선(ROC곡선)분석,판정기절단치.결과 60례원발성뇌교출혈환자30d병사솔위43.3％.단인소분석결과현시,입원시격랍사가혼미평분(GCS)、체온、심솔、출혈량、시부사용호흡궤보조호흡、혈종시부파입뇌실、혈종부위여원발성뇌교출혈환자30 d병사솔유관.다원logistic회귀분석현시,입원시GCS평분[우세비(OR=0.745,95％가신구간(95％CI)위(0.585,0.949)]、출혈량[ OR=1.438,95％CI( 1.077,1.919)]이급혈종부위[기저-피개형,OR=0.120,95％CI(0.016,0.904)]위영향원발성뇌교출혈예후적독립위험인소(균P＜0.05).ROC곡선분석현시,입원시GCS평분급출혈량적절단치분별위7.5분화5.5 ml.결론 원발성뇌교출혈환자혈종위우기저-피개부、입원시GCS평분＜7.5분、출혈량≥5.5 ml자제시30 d예후불량.
Objective To evaluate the risk factors of prognosis in patients with primary pontine hemorrhage.Methods A retrospective analysis was conducted using data from 60 patients admitted with a diagnosis of primary pontine hemorrhage to the Department of Neurology of Nanfang Hospital in Guangzhou City.Patients were classified as survivors (n=34) and non-survivors (n=26) according to their outcomes on 30 days from the onset of symptoms.Univariate analysis and multivariate logistic regression analysis were performed on clinical data and imaging features of patients.Receiver operating characteristic curve ( ROC curve) analysis was used on continuous parameters verified by multivariate logistic regression analysis to determine their cut-off value.Results The 30-day mortality was 43.3％ for 60 patients with primary pontine hemorrhage.Univariate analysis showed Glasgow coma scale (GCS) at admission,temperature,heart rate,hemorrhage volume,mechanical ventilation,involvement of ventricles and location of hematoma were statistically related to 30-day mortality in patients with primary pontine hemorrhage.Multivariate logistic regression analysis demonstrated that the GCS at admission [odds ratio (OR) =0.745,95％ eonfidence interval (95％ CI) 0.585 to 0.949],hemorrhage volume ( OR =1.438,95％ CI 1.077 to 1.919) and location of hematoma ( basal-tegmental hemorrhage,OR =0.120,95％ CI 0.016 to 0.904) were independent risk factors of poor prognosis in patients with primary pontine hemorrhage (all P＜ 0.05 ).ROC curve analysis showed the cut-off value for GCS score at admission and hemorrhage volume was 7.5 and 5.5 ml,respectively.Conclusion Patients suffering from primary pontine hemorrhage in the basal-tegmental region,GCS＜7.5 at admission and hemorrhage volume≥5.5 ml would lead to a poor outcome in 30 days.
