CAJ | 학술논문

目的采用巢式病例-对照研究分析普通外科和骨科手术患者的术后脑卒中相关预后因素.方法检索我院2009年1月至2011年12月行普通外科、骨科手术的病历,收集出院诊断有脑卒中记载的596例患者,对其中术后新发生的脑卒中患者29例(病例组),采用巢式病例-对照研究方法,按1∶6匹配同期同类未发生脑卒中手术病例174例作为对照组,探讨年龄、美国麻醉医师协会(ASA)分级、高血压、糖尿病、房颤、脑卒中或短暂性脑缺血发作(TIA)史、术中非房颤性心律失常等因素对术后脑卒中的影响.结果单因素分析显示年龄、高血压、糖尿病、脑卒中或TIA史、术中发生非房颤心律失常是术后脑卒中发生的预后因素.多因素Logistic回归分析显示术前脑卒中或TIA史、房颤及年龄是术后脑卒中发生的独立预后因素,其中脑卒中或TIA史对术后脑卒中影响最显著(OR=13.01),其次为房颤(OR=7.77)和年龄(OR=6.40).结论脑卒中或TIA史、房颤及年龄是术后脑卒中的独立预后因素.高血压、糖尿病、术中非房颤性心律失常是术后脑卒中预后因素.
목적 채용소식병례-대조연구분석보통외과화골과수술환자적술후뇌졸중상관예후인소.방법 검색아원2009년1월지2011년12월행보통외과、골과수술적병력,수집출원진단유뇌졸중기재적596례환자,대기중술후신발생적뇌졸중환자29례(병례조),채용소식병례-대조연구방법,안1∶6필배동기동류미발생뇌졸중수술병례174례작위대조조,탐토년령、미국마취의사협회(ASA)분급、고혈압、당뇨병、방전、뇌졸중혹단잠성뇌결혈발작(TIA)사、술중비방전성심률실상등인소대술후뇌졸중적영향.결과 단인소분석현시년령、고혈압、당뇨병、뇌졸중혹TIA사、술중발생비방전심률실상시술후뇌졸중발생적예후인소.다인소Logistic회귀분석현시술전뇌졸중혹TIA사、방전급년령시술후뇌졸중발생적독립예후인소,기중뇌졸중혹TIA사대술후뇌졸중영향최현저(OR=13.01),기차위방전(OR=7.77)화년령(OR=6.40).결론 뇌졸중혹TIA사、방전급년령시술후뇌졸중적독립예후인소.고혈압、당뇨병、술중비방전성심률실상시술후뇌졸중예후인소.
Objective To evaluate the prognostic factors of postoperative stroke in general and orthopedic surgeries using a nested case-control design.Methods The retrieval of information was performed from the medical records database in the Peking University Third Hospital.A total of 596 records with stroke diagnosis from January 2009 to December 2011 were recruited as the study cases,among which 29 cases were diagnosed with stroke occurred postoperatively.174 cases with similar surgical types,date of operation and anesthesia technique were explored as control group according to the principle of the nested case-control design.The data were analyzed using Logistic regression model.Results Univariate analysis showed that age,hypertension,diabetes,stroke or TIA history,non-atrial arrhythmias during surgery were prognostic factors for postoperative stroke.Logistic regression analysis showed that patients with stroke or TIA history,atrial fibrillation and age were independent prognostic factors for postoperative stroke,stroke or TIA history were the most significant factor associated with postoperative stroke (OR =13.01),followed by atrial fibrillation (OR =7.77) and age (OR =6.40).Conclusion Stroke or TIA history,atrial fibrillation,and age are independent prognostic factors for postoperative stroke.Hypertension,diabetes,and non-atrial arrhythmias during surgery are prognostic factors for postoperative stroke.