原发性脑干出血患者的预后相关危险因素分析  

Risk factors analysis of prognosis of primary brainstem hemorrhage

作　　者：游玉婷[1] 李玲文[2] 李萌芳[1] 支绍册[1] 吴斌[1] 洪广亮[1] 赵光举[1] 卢中秋[1] 

机构地区：[1]温州医科大学附属第一医院急诊科,浙江温州325000 [2]温州医科大学附属第一医院心电图室,浙江温州325000

出　　处：《全科医学临床与教育》2016年第3期267-270,共4页Clinical Education of General Practice

基　　金：浙江省中医药科技计划项目(2011ZA074);浙江省中医药重点学科计划(2012-XK-A28);浙江省"十二五"重点学科建设项目(2012-207);浙江省医学创新学科建设项目(11-CX26)

摘　　要：目的分析原发性脑干出血患者临床特点和预后相关危险因素。方法回顾总结89例原发性脑干出血患者的病例资料,采用单因素和多元logistic回归对预后相关因素进行分析。结果 89例原发性脑干出血患者死亡37例,30 d病死率为41.57%。单因素分析结果显示存活组与死亡组血肿体积、GCS≤8分、两侧瞳孔无对光反射、体温≥37.5℃、入院时呼吸机辅助通气、血肿破入脑室、并发脑积水、血糖≥8.3mmol/L例数比较,差异均有统计学意义（χ^2分别=46.34、37.80、21.50、23.63、29.19、23.23、4.68、8.34,P均〈0.05）,logistic回归显示入院时血肿体积、GCS≤8分是原发性脑干出血患者预后的相关危险因素（OR分别=4.80、7.24,P均〈0.05）。结论入院时血肿体积、GCS≤8分是原发性脑干出血患者预后相关危险因素。Objective To evaluate the clinical characteristics and risk factors of prognosis of patients with primary brainstem hemorrhage（PBH）. Methods A total of 89 patients with PBH were retrospectively reviewed. Univariate analysis and multivariate logistic regression analysis were used to evaluate the relative factors of prognosis of PBH. Results Of the89 patients,37（41.57%）were died within 30 days. Univariate analysis showed that the number of different hemorrhage volume,glasgow coma scale（GCS） ≤8,no pupillary light reflex,the temperature ≥37.5℃,mechanical ventilation,involvement of ventricles,hydrocephalus and blood glucose ≥8.3mmol/L were statistically different between survival group and death group（χ~2=46.34,37.80,21.50,23.63,29.19,23.23,4.68,8.34, P〈0.05）. Multivariate logistic regression analysis demonstrated that hemorrhage volume and GCS ≤8 were risk factors of prognosis of PBH（OR =4.80,7.24, P〈0.05）.Conclusion Hemorrhage volume and GCS≤8 were risk factors of prognosis of PBH.

关 键 词：原发性脑干出血 危险因素 病死率 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]