中国实用神经疾病杂志
中國實用神經疾病雜誌
중국실용신경질병잡지
CHINESE JOURNAL OF PRACTICAL NERVOUS DISEASES
2014年
11期
38-41
,共4页
急性重症脑血管病%危险因素%死亡风险
急性重癥腦血管病%危險因素%死亡風險
급성중증뇌혈관병%위험인소%사망풍험
Severe cerebral vascular disease%Risk factor%Risk of death
目的：分析急性重症脑血管病死亡的危险因素，预测死亡风险，以有效降低脑卒中患者的院内病死率。方法选择2008-10-2012-10于我院住院的急性重症脑血管病患者463例，采用回顾性分析方法，将研究对象的危险因素分为不可干预的Ⅰ类因素（性别、年龄、家族史）、可干预的Ⅱ类因素（高血压、脑卒中史、糖尿病、冠心病、慢性阻塞性肺病、高血脂、饮酒、吸烟）、Ⅲ类为并发症因素（上消化道出血、颅内再出血或梗死、肺部感染、心律失常、电解质紊乱、癫痫发作、多脏器功能障碍）和Ⅳ类为疾病特征因素（体温、脉搏、呼吸、收缩压、血糖、早期昏迷、Glasgow评分、溶栓、手术）共4个类别，逐项分类记录后采用多因素Logistic回归分析。结果年龄（＞70岁）、体温（＞38.5℃）、早期昏迷、高血压、脑卒中史、糖尿病、冠心病、慢性阻塞性肺病、上消化道出血、颅内再出血或梗死、肺部感染、电解质紊乱、癫痫发作、多脏器功能障碍和手术是独立危险因素，Glas-gow评分与死亡呈负相关。结论预测急性重症脑血管病死亡的关键因素，积极预防和治疗是降低重症脑血管病死亡风险的有效途径。
目的：分析急性重癥腦血管病死亡的危險因素，預測死亡風險，以有效降低腦卒中患者的院內病死率。方法選擇2008-10-2012-10于我院住院的急性重癥腦血管病患者463例，採用迴顧性分析方法，將研究對象的危險因素分為不可榦預的Ⅰ類因素（性彆、年齡、傢族史）、可榦預的Ⅱ類因素（高血壓、腦卒中史、糖尿病、冠心病、慢性阻塞性肺病、高血脂、飲酒、吸煙）、Ⅲ類為併髮癥因素（上消化道齣血、顱內再齣血或梗死、肺部感染、心律失常、電解質紊亂、癲癇髮作、多髒器功能障礙）和Ⅳ類為疾病特徵因素（體溫、脈搏、呼吸、收縮壓、血糖、早期昏迷、Glasgow評分、溶栓、手術）共4箇類彆，逐項分類記錄後採用多因素Logistic迴歸分析。結果年齡（＞70歲）、體溫（＞38.5℃）、早期昏迷、高血壓、腦卒中史、糖尿病、冠心病、慢性阻塞性肺病、上消化道齣血、顱內再齣血或梗死、肺部感染、電解質紊亂、癲癇髮作、多髒器功能障礙和手術是獨立危險因素，Glas-gow評分與死亡呈負相關。結論預測急性重癥腦血管病死亡的關鍵因素，積極預防和治療是降低重癥腦血管病死亡風險的有效途徑。
목적：분석급성중증뇌혈관병사망적위험인소，예측사망풍험，이유효강저뇌졸중환자적원내병사솔。방법선택2008-10-2012-10우아원주원적급성중증뇌혈관병환자463례，채용회고성분석방법，장연구대상적위험인소분위불가간예적Ⅰ류인소（성별、년령、가족사）、가간예적Ⅱ류인소（고혈압、뇌졸중사、당뇨병、관심병、만성조새성폐병、고혈지、음주、흡연）、Ⅲ류위병발증인소（상소화도출혈、로내재출혈혹경사、폐부감염、심률실상、전해질문란、전간발작、다장기공능장애）화Ⅳ류위질병특정인소（체온、맥박、호흡、수축압、혈당、조기혼미、Glasgow평분、용전、수술）공4개유별，축항분류기록후채용다인소Logistic회귀분석。결과년령（＞70세）、체온（＞38.5℃）、조기혼미、고혈압、뇌졸중사、당뇨병、관심병、만성조새성폐병、상소화도출혈、로내재출혈혹경사、폐부감염、전해질문란、전간발작、다장기공능장애화수술시독립위험인소，Glas-gow평분여사망정부상관。결론예측급성중증뇌혈관병사망적관건인소，적겁예방화치료시강저중증뇌혈관병사망풍험적유효도경。
Objective To investigate and analyze the risk factors of mortality in patients with acute severe cerebrovascular disease ,in order to predict the death risk and reduce hospital mortality in acute cerebral apoplexy. Methods From July 2008 to July 2012 ,a total of 453 cases of patients with acute severe cerebrovascular disease in our hospital were selected ,and retrospec-tive method was performed. According to the characters of the different factors ,all of the risk factors were divided into four kinds. Type Ⅰ or the unchangeable factors were gender ,age ,family history ;type Ⅱ or the interfered factors included hyper-tension ,history of stroke ,diabetes ,coronary heart disease ,chronic obstructive pulmonary disease ,high blood lipids ,drinking and smoking ;type Ⅲ contained upper gastrointestinal hemorrhage ,intracranial re-hemorrhage or re-infarction ,arrhythmia , pulmonary infection ,electrolyte disturbances ,epilepsy and multiple organ dysfunction ;type Ⅳ were temperature ,pulse ,res-piration ,systolic blood pressure ,blood glucose ,early step coma ,Glasgow score ,thrombolysis and operation.Results Age (>70 years) ,temperature(> 38.5℃) ,early step coma ,hypertension ,history of stroke ,coronary heart disease ,diabetes , chronic obstructive pulmonary disease ,upper gastrointestinal hemorrhage ,intracranial re-hemorrhage or re-infarction ,pulmo-nary infection ,electrolyte disturbance ,seizures ,multiple organ dysfunction and operation were independent risk factors ,and the probability of death was negatively related to Glasgow scores.Conclusion Prediction of the key factors of death of acute se-vere cerebrovascular disease ,and active prevention and treatment ,was an effective way to reduce the risk of death.
