摘要
目的 探讨自发性幕上脑出血患者行锥颅抽吸血肿治疗术后 30 d死亡的危险因素 ,建立其死亡概率预测模型。方法 回顾性分析我院近 6年来病房收治的 113例行锥颅抽吸血肿治疗的自发性幕上脑出血病例 ,对影响自发性幕上脑出血患者行锥颅抽吸血肿治疗术后生存的危险因素进行多元 L ogistic回归分析。结果 113例病人 ,术后 30 d病死率为 2 7.4 %。单因素检验表明 ,意识水平、出血量、出血半球、伴发缺血性心脏病和锥颅手术时间是影响自发性幕上脑出血患者行锥颅抽吸血肿治疗术后 30 d死亡的危险因素。多因素 L ogistic回归分析发现 ,意识水平 (OR =2 .6 0 6 ,P <0 .0 1)和出血量 (OR =1.0 38,P <0 .0 1)是重要的危险暴露因子 ,锥颅时间是保护因子 (OR =0 .6 4 5 ,P <0 .0 5 )。其死亡概率预测模型表达式为 :L ogit P =- 4 .0 35 +1.0 19X意识 +0 .0 38X出血量 - 0 .4 16 X锥颅时间 。该模型预测急性期行锥颅抽吸血肿治疗幕上脑出血患者术后 30 d生存的灵敏度为 90 .2 %。结论 急性期行锥颅抽吸血肿治疗幕上脑出血患者术后 30
Objective To determine the important risk factors of 30 day death in patients with supratentorial cerebral hemorrhage after stereotaxic aspirate hematom, and to develop a model for predicting the mortality. Methods We retrospectively reviewed the medical records and CT scans of 113 inpatients with supratentorial cerebral hemorrhage treated by stereotaxic aspiration. Independent risk factors were determined by multivariate logistic regression analysis. Results The mortality of the 113 cases of supratentorial cerebral hemorrhage with stereotaxic aspirate hematom was 27.4%. Univariate analysis showed that initial level of consciousness, hemorrhage size, hemorrhage hemishere, concomitant ischemic heart disease and the time of stereotaxic aspiration were significantly correlated with outcome 30 day after stereotaxic aspirate hematom. But multivariate logistic regression analysis showed that initial level of consciousness(OR=2.606, P<0.01)and hemorrhage size (OR=1.038, P<0.01)were significant independent risk factors, the time of stereotaxic aspiration(OR= 0.645 , P<0.05) was significant independent protective factor of 30 day mortality. The model for predicting the 30 day mortality is Logit P=-4.035+ 1.019 X level of consciousness +0.038X hemorrhage size -0.416X time of stereotaxic aspiration . The model can predict 30 day survival with the sensitivity of 90.2%. Conclusions The model for predicting the 30 day mortality could provide powerful evidence for treatment.
出处
《疾病控制杂志》
2003年第1期19-22,共4页
Chinese Journal of Disease Control and Prevention
