摘要
目的：探讨脑梗死恢复期患者在康复科住院过程中死亡的相关影响因素。方法：回顾性分析2013年1月~2014年12月在本院康复医学科住院期间死亡的23例脑梗死恢复期患者的临床资料，对其一般资料、基础病变及入院时NIHSS、ADL评定等进行统计分析，并与对照组进行比较。结果：脑梗死恢复期住院期间死亡率为1.04%，其中肺部感染并呼吸衰竭12例（52.17%）、急性心肌梗塞3例（13.04%）、卒死2例（8.70%）、急性心衰2例（8.70%）、再发大面积梗塞2例（8.7%）、上消化道出血1例（4.35%）、肾功能衰竭1例（4.35%）；与对照组比较，两组在高龄（〉70岁）、房颤史、大面积梗塞、合并肺部感染、血浆白蛋白水平及入院时NIHSS量表、ADL量表评分等方面差异均有统计学意义（P〈0.05、P〈0.01），高血压、糖尿病、冠心病等单一基础病变方面差异无统计学意义（P〉0.05）。结论：脑梗死恢复期患者康复治疗期间的病死率与患者的高龄、梗塞面积、房颤，血浆白蛋白水平及神经功能缺损程度、日常生活能力水平、合并肺部感染等均有密切关系，尤其肺部感染是导致直接死亡的最主要原因。
Objetive：To investigate the death-related factors and causes of death in patients with cerebral infarction during the recovery period in reha-bilitation department. Methods：Clinical data of 23 cases of patients with cerebral infarction who were dead during the recovery period in rehabilita-tion medical department of our hospital were retrospective analyzed, and statistical analyzed their general information, basic pathological changes and NIHSS, ADL on admission, and compared with control group. Results：The hospital mortality in patients with cerebral infarction during the re-covery period was 1.04%, the leading direct cause of death were 12 cases of pneumonia and respiratory failure （52.17%）, 3 cases of acute myocardial infarction （13.04%）, 2 cases of sudden death （8.70%）, 2 cases of acute heart failure （8.70%）, 2 cases of recurrent massive cerebral infarction （8.70%）, 1 case of upper digestive tract bleeding （4.35%）, 1 case of renal failure （4.35%）. There were differences between the observation group and the con-trol group in advanced age （〉70）, massive cerebral infarction, atrial fibrillation, pneumonia, plasma albumin level and the assessment score of NI-HSS and ADL （P〈0.05、P〈0.01）, while single basal lesions such as hypertension, diabetes and coronary heart disease was no statistically differences （P〈0.05）. Conclusion：The death risk factors in the duration of recovery of cerebral infarction related to advanced age, massive cerebral infarction, atrial fibrillation, the low level of plasma albumin and the higher NIHSS score and the lower ADL score at admission, especially pneumonia and re-spiratory failure were the most direct cause of death.
出处
《按摩与康复医学》
2015年第19期26-28,共3页
Chinese Manipulation and Rehabilitation Medicine
关键词
脑梗死
恢复期
康复科
住院患者
死亡
死因分析
cerebral infarction
recovery period
rehabilitation department
inpatient
death
death cause analysis
