急性脑卒中与上消化道出血相关因素分析  

Analysis of related factors of acute cerebral apoplexy combined with upper gastrointestinal hemorrhage

作　　者：任爱民[1] 陆一平[1] 潘勤[1] 

机构地区：[1]武警江苏总队南京医院,南京210028

出　　处：《军医进修学院学报》2004年第4期261-263,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的 :探讨急性脑卒中并发上消化道出血相关的危险因素。方法 :对 391例急性脑卒中住院患者的临床资料 ,按年龄、脑卒中类型、病变部位、病情程度、病死率及上消化道出血发生率六个方面进行回顾性分析。结果 :391例急性脑卒中并发上消化道出血 6 2例 ,发生率为 15 .9% ,上消化道出血随年龄增长而多发 ,≥ 70岁者占5 1.6 % ,出血性脑卒中组明显高于缺血性脑卒中组 (P <0 .0 1) ,丘脑出血、脑出血破入脑室高于其它部位出血(P <0 .0 5 ,P <0 .0 1) ,大面积脑梗死、多发性脑梗死高于其它脑梗死 (P <0 .0 1,P <0 .0 5 ) ,重型脑卒中高于轻、中型 (P <0 .0 1) ,并发上消化道出血组病死率 2 4 .2 % ,未并发出血组病死率 3.6 % ,两组间差异非常显著 (P <0 .0 1)。结论 :急性脑卒中并发上消化道出血与脑卒中类型、病变部位、病情危重程度等危险因素相关。Objective:To study the related dangerous factors of acute cerebral apoplexy (ACA) combined with upper gastrointestinal hemorrhage (UGH).Methods:By investigating the clinical data of 391 cases of acute cerebral apoplexy in hospital, we retrospectively analyze such aspects as age, the type of cerebral apoplexy, the position of pathological changes, the degree of the illness, the death rate of illness and the incidence rate of upper gastrointestinal hemorrhage.Results:There are 62(15.9%) cases of ACA combined with UGH in 391 cases of ACA. The incidence rate increases with the growing age, and the percentage is 51.6% when the age is ≥ 70 years. The rate of bleeding cerebral apoplexy is obviously larger than that of ischemia one(P<0.01). The rate of thalamus bleeding, apoplexy entering cerebral ventricle is larger than that of bleeding at other positions (P<0.05,P<0.01).The rate of cerebral infarction in large area, frequent cerebral infarction is larger than that of other ones (P<0.05,P<0.010). The rate of the serious cerbral apoplexy is larger than that of the slight one or medium-degree one(P<0.01). There is a very significant difference (P<0.01)between the death rate of cerebral apoplexy combined with UGH (24.2%) and that of cerebral apoplexy combined with no UGH (3.6%). Conclusion:ACA combined with UGH is correlated with the type of cerebral apoplexy, the position of pathological changes and the degree of the illness.

关 键 词：急性脑卒中 上消化道出血 危险因素 并发症 

分 类 号：R573.2[医药卫生—消化系统] R743.3[医药卫生—内科学]