自发性脑出血神经功能恶化的相关因素临床分析  

Clinical analysis of related factors of neurological deterioration in spontaneous intracerebral hemorrhage

作　　者：施雪英[1] 袁良津[1] 蒋鸣坤[1] 顾尚恒[1] 曹莉[1] SHI Xueying;YUAN Liangjin;JIANG Mingkun;GU Shangheng;CAO Li(Department of Neurology,Anqing Hospital Affiliated to Anhui Medical University,anqing,Anhui 246003,China)

机构地区：[1]安徽医科大学附属安庆医院神经内科,安徽安庆246003

出　　处：《安徽医药》2018年第7期1286-1289,共4页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省卫生厅医学科研自筹项目(2010C114)

摘　　要：目的分析相关因素与自发性脑出血(intracerebral hemorrhage,ICH)的关联性,为临床干预提供依据。方法收集2013年12月至2016年3月安徽医科大学附属安庆医院住院治疗的247例脑出血患者,根据是否发生神经功能恶化(neurological deterioration,ND)及时间分为非ND、72 h内ND与72 h后ND组,分析不同组脑出血患者各危险因素与ND的独立相关性。结果 247例患者中,其中非ND组189例,72 h内ND组31例,72 h后ND组27例。多元回归分析发现,血肿形状不规则(OR=1.136,95%CI 1.001~1.290,P=0.048)、破入脑室(OR=1.693,95%CI 1.145~2.502,P=0.009)与72 h内发生ND呈独立相关。未鼻饲(OR=1.126,95%CI 1.019~1.244,P=0.020)、肺部感染(OR=1.216,95%CI 1.045~1.415,P=0.012)与72 h后发生ND独立相关。结论血肿形状不规则、血肿破人脑室是72 h内ND的独立危险因素,未鼻饲、肺部感染是72 h后ND的独立危险因素。Objective To analyze the correlation between the related factors and intracerebral hemorrhage（ ICH）,and to provide the basis for clinical intervention. Methods 247 cases of intracerebral hemorrhage were collected from December 2013 to March 2016.According to the occurrence and the time of neurological deterioration（ ND） is divided into non-ND,72 hours ND and 72 hours after the ND group. The independent correlation was analyzed between risk factors and ND. Results Among 247 cases,189 cases were non-ND group,31 cases were ND group within 72 hours,and 27 cases were ND group 72 hours later. Multiple regression analysis showed that the Irregular hematoma shape（ OR = 1. 136,95% CI 1. 001 ~ 1. 290,P = 0. 048 0. 05） and Hematoma broke into the ventricle（ OR = 1. 693,95% CI 1. 145 ~ 2. 502,P = 0. 009 0. 01） was independently associated with ND within 72 hours,No nasal feeding（ OR = 1. 126,95% CI 1. 019 ~ 1. 244,P = 0. 020 0. 05） and pulmonary infection（ OR = 1. 216,95% CI 1. 045 ~ 1. 415,P = 0. 012 0. 05） was independently associated with ND 72 hours after. Conclusions The Irregular hematoma shape and Hematoma broke into the ventricle is the independent risk factor of ND in 72 hours. No nasal feeding and pulmonary infection is the independent risk factor of ND after 72 hours.

关 键 词：脑出血 肺炎 插管法 胃肠 磁共振成像 危险因素 因素分析 统计学 神经功能恶化 

分 类 号：R743.34[医药卫生—神经病学与精神病学]