重症高血压脑出血患者术后压力性损伤发生的影响因素

Influencing Factors of Postoperative Stress Injury in Patients with Severe Hypertensive Intracerebral Hemorrhage

目的分析重症高血压脑出血患者术后压力性损伤(PI)发生的影响因素。方法回顾性分析,收集南华大学附属第二医院2018年6月-2020年6月收治的80例重症高血压脑出血患者,其中发生压力性损伤者40例(发生组),未发生压力性损伤者40例(未发生组)。统计两组患者年龄、性别、发病至入院时间等临床资料,经单因素、多因素分析重症高血压脑出血患者术后发生PI的影响因素。结果两组年龄、发病至入院时间、体重指数(BMI)、格拉斯哥昏迷评分(GSD)、性别、营养支持相比,差异无统计学意义(P>0.05);两组Fugl-Meyer运动功能量表评分(FMA)、合并糖尿病、大小便情况相比,差异有统计学意义(P<0.05)。经Logistic回归分析显示,FMA评分低、合并糖尿病、大小便失禁是导致重症高血压脑出血患者术后发生PI的影响因素(OR>1,P<0.05)。结论FMA评分低、合并糖尿病、大小便失禁是导致重症高血压脑出血患者术后发生PI的影响因素。

Objective To analyze the influencing factors of postoperative stress injury(PI)in patients with severe hypertensive intracerebral hemorrhage.Methods A total of 80 patients with severe hypertensive intracerebral hemorrhage admitted to the Second Affiliated Hospital of Nanhua University from June 2018 to June 2020 were retrospectively analyzed,including 40 patients with stress injury(occurrence group)and 40 patients without stress injury(non occurrence group).The clinical data such as age,gender,time from onset to admission of the two groups were statistically analyzed.The influencing factors of PI in patients with severe hypertensive intracerebral hemorrhage were analyzed by univariate and multivariate analysis.Results There were no significant differences in age,onset to admission time,body mass index(BMI),Glasgow Coma Score(GSD),gender and nutritional support between the two groups(P>0.05);there were significant differences in Fugl Meyer motor function scale score(FMA),diabetes mellitus and defecation between the two groups(P<0.05).Logistic regression analysis showed that low FMA score,diabetes mellitus,urinary incontinence were the influencing factors of postoperative PI in patients with severe hypertensive cerebral hemorrhage(OR>1,P<0.05).Conclusion Low FMA score,diabetes mellitus and incontinence are the influencing factors of postoperative PI in patients with severe hypertensive intracerebral hemorrhage.