摘要
目的探讨急性脑出血患者死亡的各种危险因素,为临床治疗提供依据。方法对上海市第一人民医院宝山分院2002年1月-2007年6月急诊及住院部住院的308例急性脑出血患者的有关指标与预后(存活或死亡)的关系进行单因素和多因素分析。结果Logistic多因素分析显示,出血量(OR=1.095,95%CI为1.053～1.139,P=0.000)、脑疝形成(OR=3.893,95%CI为1.133～14.005,P=0.031)、入院时的格拉斯哥昏迷评分(OR=0.922,95%CI为0.885～0.957,P=0.000)、感染(OR=8.382,95%CI为2.333～30.117,P=0.001)、多器官功能衰竭(OR=22.568,95%CI为2.987～170.445,P=0.003)、上消化道出血(OR=8.795,95%CI为1.433～53.931,P=0.019)是影响死亡的危险因素。结论积极营养支持、降低颅内压、头部亚低温、防止并发症是改善预后的重要环节。
Objective To investigate the risk factors of mortality in patients with acute cerebral hemorrhage, so as to provide theoretical evidence for clinical treatment. Methods Totally 308 patients with acute intracerebral hemorrhage, who were treated in our hospital during Jan. 2002 to Jun. 2007, were included in the present study. The relation between related indices and outcomes was analyzed by univariate and multivariate analysis. Results Logistic Stepwise Regression Analysis showed that the risk factors of patient mortality included the volume of hemorrhage （ OR = 1. 095, 95% CI ： 1. 053-- 1. 139, P = 0. 000）, median line aversion （ OR = 3. 893, 95 % CI = 1. 133 - 14. 005, P = 0.031 ）, Glasgow coma scale （ OR = 0： 922, 95 % CI = 0. 885 - 0. 957, P = 0. 000）, infection （ OR = 8. 382, 95 % CI ; 2. 333 - 30.117, P = 0.001 ）, multiple organ failure （ OR = 22. 568, 95 % CI ： 2. 987 - 170. 445, P = 0. 003）, and upper gastrointestinal hemorrhage （ OR = 8. 795, 95 % OI ： I. 433 - 53.931, P= 0.019）. Conclusion Prompt nutritional support, decrease of intracranial pressure, sub-low temperature treatment of head, and prevention of complication are the major measures to improve patients prognosis. （Shanghai Meal J, 2009, 32.. 614-616）
出处
《上海医学》
CAS
CSCD
北大核心
2009年第7期614-616,共3页
Shanghai Medical Journal
关键词
脑出血
预后
LOGISTIC回归分析
Intracerebral hemorrhage
Prognosis
Logistic regression analysis
