中国急救复苏与灾害医学杂志
中國急救複囌與災害醫學雜誌
중국급구복소여재해의학잡지
CHINA JOURNAL OF EMERGENCY RESUSCITATION AND DISASTER MEDICINE
2013年
12期
1077-1080
,共4页
杨铁城%于东明%李建国%任添华%李丽霞%董小燕
楊鐵城%于東明%李建國%任添華%李麗霞%董小燕
양철성%우동명%리건국%임첨화%리려하%동소연
脑出血%消化道出血%危险因素%应激性溃疡预防
腦齣血%消化道齣血%危險因素%應激性潰瘍預防
뇌출혈%소화도출혈%위험인소%응격성궤양예방
Intracerebral hemorrhage%Gastrointestinal bleeding%Risk factors%Stress ulcer prophylaxis
目的:回顾性分析北京天坛医院急诊科808例自发性脑出血(ICH)的病历资料,研究消化道出血的发生率,危险因素及应激性溃疡预防措施(SUP)。方法回顾性分析808例ICH的病历资料,比较消化道出血组与未发生消化道出血组的临床资料的差异。Logistic回归分析消化道出血发生的危险因素。结果808例ICH患者中,消化道出血发生率为26.7%,其中3例发生严重消化道出血。多因素logistic回归显示,年龄、血肿体积、格拉斯哥评分(GCS)及脓毒症是消化道出血的独立预测因子。高达63.4%的患者接受了SUP,SUP组的消化道出血发生率显著高于非SUP组(30.9%vs 19.6,P<0.01)。结论ICH后消化道出血发生率较高,但严重消化道出血少见。年龄、血肿体积、GCS及脓毒症是消化道出血的独立预测因子。SUP对于消化道出血的预防价值仍需进一步研究确立。
目的:迴顧性分析北京天罈醫院急診科808例自髮性腦齣血(ICH)的病歷資料,研究消化道齣血的髮生率,危險因素及應激性潰瘍預防措施(SUP)。方法迴顧性分析808例ICH的病歷資料,比較消化道齣血組與未髮生消化道齣血組的臨床資料的差異。Logistic迴歸分析消化道齣血髮生的危險因素。結果808例ICH患者中,消化道齣血髮生率為26.7%,其中3例髮生嚴重消化道齣血。多因素logistic迴歸顯示,年齡、血腫體積、格拉斯哥評分(GCS)及膿毒癥是消化道齣血的獨立預測因子。高達63.4%的患者接受瞭SUP,SUP組的消化道齣血髮生率顯著高于非SUP組(30.9%vs 19.6,P<0.01)。結論ICH後消化道齣血髮生率較高,但嚴重消化道齣血少見。年齡、血腫體積、GCS及膿毒癥是消化道齣血的獨立預測因子。SUP對于消化道齣血的預防價值仍需進一步研究確立。
목적:회고성분석북경천단의원급진과808례자발성뇌출혈(ICH)적병력자료,연구소화도출혈적발생솔,위험인소급응격성궤양예방조시(SUP)。방법회고성분석808례ICH적병력자료,비교소화도출혈조여미발생소화도출혈조적림상자료적차이。Logistic회귀분석소화도출혈발생적위험인소。결과808례ICH환자중,소화도출혈발생솔위26.7%,기중3례발생엄중소화도출혈。다인소logistic회귀현시,년령、혈종체적、격랍사가평분(GCS)급농독증시소화도출혈적독립예측인자。고체63.4%적환자접수료SUP,SUP조적소화도출혈발생솔현저고우비SUP조(30.9%vs 19.6,P<0.01)。결론ICH후소화도출혈발생솔교고,단엄중소화도출혈소견。년령、혈종체적、GCS급농독증시소화도출혈적독립예측인자。SUP대우소화도출혈적예방개치잉수진일보연구학립。
Objective To analyze 808 cases of spontaneous intracerebral hemorrhage (ICH) and the correlation with gastrointestinal (GI) bleeding. Methods A retrospective review was conducted of the medical records of 808 ICH patients. Specifically, clinical parameters of ICH patients with subsequent GI bleeding were compared to those of patients without GI bleeding. These parameters included Glasgow Coma Scale (GCS) scores, head computed tomography findings (i.e., sites of ICH, ICH volume, and intraventricular extension of hemorrhage) at admission, treatments, application of stress ulcer prophylaxis (SUP), sepsis, length of hospital stay, in-hospital mortality, and modified Rankin Scale (mRS) scores at discharge. Risk factors for GI bleeding were identified using logistic regression analysis. Results The incidence of GI bleeding was 26.7%, including three cases of severe GI bleeding (0.35%). Patients with GI bleeding had significantly longer hospital stay and higher in-hospital mortality compared with patients without GI bleeding. Multivariate logistic regression analyses showed that age, GCS score, sepsis and ICH volume were independent predictors of GI bleeding. About 63.4%of patients who received SUP had significantly higher incidences of GI bleeding than those who did not receive SUP. Conclusion GI bleeding occurred frequently following ICH, but severe events were rare. Age, GCS score, sepsis, and ICH volume were independent predictors of GI bleeding occurring after ICH.