脑溢血术后复发影响因素分析  

Analysis on influence factors of stroke recurrence

作　　者：张学磊[1] 叶碎林[1] 刘进[1] 任明军[1] 

机构地区：[1]浙江省丽水市人民医院神经外科,浙江丽水323000

出　　处：《中国健康教育》2014年第8期723-725,734,共4页Chinese Journal of Health Education

摘　　要：目的了解脑溢血术后复发的相关因素,为健康教育策略的制定提供科学依据。方法采用方便抽样方法选取2012年1月—2014年1月进行微创颅脑穿刺术治疗的脑溢血复发患者75例;同期选取脑溢血未复发患者75例,调查既往病史、手术、高血压控制情况等资料,分析脑溢血复发的危险因素。结果调查对象复发比例中,文化程度中小学及以下最高(56.52%);病史中患有高血压最高(51.49%);术后血压偏高(61.70%)高于血压正常(30.36%);酗酒(61.02%)高于不酗酒(42.86%);吸烟(59.49%)高于不吸烟(39.44%);术后从不康复训练最高(61.54%);术后抑郁(64.91%)高于不抑郁(40.86%),均P<0.05。多因素分析显示发病至手术时间<6 h(OR=1.87,95%CI:1.34～5.48)、术中抽吸量≥60%(OR=3.03,95%CI:1.09～6.04)、术后高血压偏高(OR=3.42,95%CI:1.40～8.31)、术后抑郁(OR=2.81,95%CI:1.22～6.50)是脑溢血复发的危险因素,大专及以上文化(OR=0.31,95%CI:0.14～0.69)、经常进行康复训练(OR=0.39,95%CI:0.17～0.92)是脑溢血复发的保护因素。结论脑溢血术后患者复发的危险因素复杂,增强患者对脑溢血复发相关知识的了解,可减少术后复发率;应加强对脑溢血术后患者复发的防治工作,通过健康教育提高患者对复发危险因素的认识并提高自我防护能力。Objective To explore the factors related to stroke recurrence, provide a scientific basis for the development of health education strategies. Metheds Used convenience sampling method to select patients with recurrent stroke 75 cases from January 2012 to January 2014 minimally invasive treatment of brain puncture; selected 75 patients without recurrence of cerebral hemorrhage in the same period, investigated past medical history, surgery, blood pressure control of such information, analyze brain hemorrhages recurrence risk factors. Results Recurrence ratio of primary and secondary education level is the highest （56. 52% ）; medical history of hypertension highest （51.49%）; postoperative high blood pressure （61.70%） 30. 36% above normal; alcoholism （61.02%） high at no alcohol （42.86%） ; smoking （59.49%） than non-smokers （39.44%） ; postoperative rehabilitation is never the highest （61.54%） ; postoperative depression （64. 91% ） higher than that of depression （40. 86% ） , （all P 〈 0. 05 ）. Multivariate analysis showed that the onset to surgery 〈 6 h （ OR = 1.87, 95% CI： 1.34 - 5.48）, intraoperative aspiration volume I〉 60% （ OR = 3.03, 95% CI： 1.09 - 6. 04）, after high blood pressure （ OR = 3.42, 95% CI： 1.40 - 8.31 ） , postoperative depression （ OR = 2. 81, 95% CI： 1.22 -6. 50） were risk factors for stroke recurrence, college and higher education （OR =0. 31, 95% CI： 0. 14 - 0. 69 ）, regular rehabilitation training （ OR = 0. 39, 95% CI： 0. 17 - 0. 92 ） is a protective factor for stroke recurrence. Conclusion Risk factors for stroke relapse are complex, enhanced understanding of stroke recurrence in patients with relevant knowledge, can reduce the recurrence rate; should strengthen the prevention and treatment of stroke patients relapse, raise awareness of relapse in patients with risk factors through health education and improve self-defense capability.

关 键 词：脑溢血 复发 危险因素 

分 类 号：R193[医药卫生—卫生事业管理] R743.34[医药卫生—公共卫生与预防医学]