摘要
目的探讨重症脑卒中患者并发危重症性多发性神经病(CIP)的发生率以及其危险因素。方法148例重症脑卒中患者,在发病后1周内和1个月后各进行1次四肢EMG检查,观察并统计:(1)CIP发生率。(2)并发CIP的患者和未并发CIP的患者一般情况比较。(3)并发CIP可能的危险因素分析。结果(1)共有23例患者并发CIP(15.54%)。(2)并发CIP和未并发CIP的两组患者之间进行比较,在性别比例、基础疾病构成、入院时急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、昏迷、高血糖、静脉使用神经阻滞剂和静脉使用肾上腺糖皮质激素方面均无统计学差异(均P>0.05),并发CIP患者在年龄、并发脓毒症、并发多器官功能衰竭(MOF)、建立人工气道情况、有创机械通气、并发营养不良和使用肠外营养方面显著高于未并发CIP患者(均P<0.05)。(3)重症脑卒中患者并发CIP的危险因素有60岁以上、脓毒症、MOF、建立人工气道、有创机械通气、营养不良和使用肠外营养;Logistic多因素回归分析发现,脓毒症、MOF、有创机械通气、营养不良是重症脑卒中患者并发CIP的独立危险因素。结论脓毒症、MOF、有创机械通气、营养不良是重症脑卒中患者并发CIP的独立危险因素。
Objective To explore complicated incidence and risk factors of critical illness polyneuropathy(CIP)in severe stroke patients.Methods One hundred and forty-eight severe stroke patients were implemented EMG examination of limbs in 1 week and after 1 month after onset.The following items were studied and analysed:(1)The incidence of CIP in the patients.(2)The differences of general conditions between the patients complicated with and without CIP.(3)The possible risk factors of CIP.Results(1)Twenty-three cases were complicated with CIP(15.54%).(2)There were no statistics difference in gender ratio,basic diseases,acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ)score at admission,coma,hyperglycemia,intravenous of nerve blockers and adrenocorticosteroids between the patients complicated with and without CIP(all P>0.05).Compared with patients without CIP,patients with CIP were significantly higher in age,sepsis,multiple organs failure(MOF),establishment of artificial airway,invasive mechanical ventilation,malnutrition and parenteral nutrition(all P<0.05).(3)The risk factors of CIP in severe stroke patients were over 60 years old,sepsis,MOF,artificial airway establishment,invasive mechanical ventilation,malnutrition and parenteral nutrition.Logistic regression analysis showed that sepsis,MOF,invasive mechanical ventilation and malnutrition were independent risk factors in severe stroke patients complicated with CIP.Conclusion Sepsis,MOF,invasive mechanical ventilation and malnutrition are independent risk factors in severe stroke patients complicated with CIP.
作者
张津华
蔡慧敏
赵燕
张宁
李江坤
付志新
ZHANG Jin-hua;CAI Hui-min;ZHAO Yan(Department of Rehabilitation,Kaifeng Central Hospital in Henan Province,Kaifeng 475000,China)
出处
《临床神经病学杂志》
CAS
2019年第6期426-431,共6页
Journal of Clinical Neurology
