基底节高血压性脑出血患者多器官功能障碍综合征发生情况及其影响因素的临床研究  

Clinical study on the occurrence of multiple organ dysfunction syndrome in patients with basal ganglia hypertensive intracerebral hemorrhage and its influencing factors

作　　者：薛小红 马双媛 曹金华 刘克洪 XUE Xiaohong;MA Shuangyuan;CAO Jinhua(Department of Neurosurgery,Marine Police Corps Hospital,Armed Police Force,Jiaxing 314000,China)

机构地区：[1]武警海警总队医院神经外科,嘉兴314000

出　　处：《临床神经病学杂志》2023年第6期410-414,共5页Journal of Clinical Neurology

基　　金：浙江省医药卫生科技计划(2020KY776)。

摘　　要：目的探讨基底节高血压性脑出血患者多器官功能障碍综合征(MODS)发生情况,并分析其影响因素。方法选取我院收治的100例基底节高血压性脑出血患者为研究对象,根据MODS发生与否分为MODS组与非MODS组。采用Logistic回归分析相关影响因素,并采用ROC曲线评价Logistic回归模型预测价值。结果Logistic回归分析显示,年龄、发病至入院时间、血肿体积、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、术后机械通气时间、空腹血糖、延迟手术均为基底节高血压性脑出血患者MODS发生的独立危险因素,GCS评分为基底节高血压性脑出血患者MODS发生的独立保护因素(均P<0.05)。根据预测值和真实值绘制ROC曲线显示,当Log(P)>3.74时,敏感度为84.62%,特异度为90.16%。部分标准化方法计算标准回归系数得出独立影响因素重要性排序依次为APACHEⅡ评分、年龄、空腹血糖、血肿体积、术后机械通气时间、GCS评分、发病至入院时间、延迟手术。结论受年龄、发病至入院时间、血肿体积、APACHEⅡ评分、术后机械通气时间、空腹血糖等多因素影响,基底节高血压性脑出血患者存在MODS风险,应加强对上述因素的管理,以降低MODS发生率。Objective To investigate the occurrence of multiple organ dysfunction syndrome(MODS)in patients with basal ganglia hypertensive intracerebral hemorrhage,and analyze its influencing factors.Methods A total of 100 patients with cerebral hemorrhage in our hospital were selected as the research objects.Patients were divided into MODS group and non-MODS group according to whether or not the occurrence of MODS occurred.The clinical data of the two groups were collected.Logistic regression was used to analyze related influencing factors,and ROC curve was used to evaluate the predictive value of Logistic regression model.Results The Logistic regression equation showed that age,time from onset to admission,hematoma volume,Acute Physiology and Chronic Health Status Rating System Ⅱ(APACHEⅡ)score,duration of postoperative mechanical ventilation,fasting plasma glucose(FPG)and delayed surgery were all independent risk factors for the occurrence of MODS in patients with basal ganglia hypertensive cerebral haemorrhage,and GCS score was an independent protective factor for the occurrence of MODS in patients with basal ganglia hypertensive cerebral haemorrhage(all P<0.05).The ROC curve plotted according to predicted and true values showed that when Log(P)>3.74,the sensitivity was 84.62% and the specificity was 90.16%;the standard regression coefficients calculated by the partial standardization method yielded that in the Logistic regression analysis.The independent influencing factors in order of importance were APACHEⅡscore,age,FPG,haematoma volume,postoperative mechanical ventilation time,GCS score,time from onset to admission,and delayed surgery.Conclusions Affected by many factors such as age,time from onset to hospital admission,hematoma volume,APACHEⅡ score,postoperative mechanical ventilation time,FPG and so on,patients with cerebral hemorrhage are at risk of MODS.In clinical work,the management of the above factors can be strengthened to reduce the incidence of MODS.

关 键 词：基底节 影响因素 多器官功能障碍综合征 预测价值 

分 类 号：R743.34[医药卫生—神经病学与精神病学]