摘要
目的探讨自发性颅内出血(spontaneous intracerebral hemorrhage,SIH)患者30 d内死亡的危险因素。方法回顾性分析2012-01至2016-01医院收治的SIH患者324例。30 d内死亡82例,为死亡组,其余242例存活患者为存活组,统计分析两组患者入院时主要临床特征。单因素和多因素logistic回归分析显示格拉斯哥昏迷评分降低、糖尿病、小脑出血、出血量增加和脑室出血等死亡的危险因素。结果与存活组比较,死亡组年龄显著偏大[(54.38±12.47)岁vs(51.73±11.94)岁,P=0.028];高血压病显著增加(68.29%vs 55.79%,P=0.047),;糖尿病显著增加(46.34%vs 27.69%,P=0.002);吸烟率显著增加(35.37%vs 21.07%,P=0.009);小脑出血率显著增高(20.73%vs 8.68%,P=0.003);脑室出血率显著增高(74.39%vs 54.96%,P=0.002);手术率显著降低(20.73%vs 37.19%,P=0.006);出血量显著增多[(110.98±36.96)ml vs(77.04±31.81)ml,t=4.922,P=0.000];格拉斯哥昏迷评分显著降低(7.52±2.70 vs 9.54±2.06,t=4.207,P=0.000)。结论格拉斯哥昏迷评分降低、糖尿病、小脑出血、出血量增加和脑室出血是SIH患者30 d内死亡的危险因素。
Objective To explore the risk factors of 30-day mortality in patients with spontaneous intracranial hemorrhage（SIH）. Methods Three hundred and twenty-four patients with SIH admitted to our hospital between January 2012 and January 2016 were retrospectively studied. Eight-two patients who died within 30 days were assigned to a death group,while another 242 survivors were assigned to a survival group. The main clinical features of both groups were observed. Univariate and multivariate logistic regression analysis was used to study such risk factors for death as a decrease of Glasgow coma score,diabetes,cerebellar hemorrhage,an increased amount of hemorrhage and intraventricular hemorrhage. Results When compared with the survival group,patients in the death group had significantly older ages（54. 38 ± 12. 47 vs 51. 73 ± 11. 94,P = 0. 028）,a higher rate of hypertension（68. 29% vs55. 79%,P = 0. 047）,diabetes（46. 34% vs 27. 69%,P = 0. 002） and of smoking（35. 37% vs 21. 07%,P = 0. 009）. The rate of cerebellar hemorrhage increased apparently（20. 73% vs 8. 68%,P = 0. 003）,the rate of intraventricular hemorrhage increased significantly（74. 39% vs 54. 96%,P = 0. 002）,the surgical rate decreased（20. 73% vs 37. 19%,P = 0. 006）,the amount of bleeding increased apparently [（110. 98 ± 36. 96） ml vs（77. 04 ± 31. 81） ml,t = 4. 922,P = 0. 000] and the Glasgow coma score decreased significantly（7. 52 ± 2. 70 vs 9. 54 ± 2. 06,t = 4. 207,P = 0. 000）. Conclusions A decrease in Glasgow coma scale,diabetes,cerebellar hemorrhage,an increased amount of hemorrhage and cerebral ventricular hemorrhage are risk factors for 30-day mortality in patients with SIH.
出处
《武警医学》
CAS
2017年第9期902-904,908,共4页
Medical Journal of the Chinese People's Armed Police Force
关键词
自发性颅内出血
死亡
危险因素
多因素回归分析
spontaneous intracranial hemorrhage
death
risk factors
muhiple regression analysis
