高血压脑出血患者引发多器官功能障碍综合征临床流行病学分析

Clinical epidemiology analysis of multiple organ dysfunction syndrome induced by hypertensive cerebral hemorrhage

目的研究高血压脑出血患者引发多器官功能障碍(MODS)的发生率、病死率及相关危险因素。方法用流行病学方法前瞻性分析968例高血压脑出血患者的临床资料。结果MODS发生率为17.05%,MODS患者死亡率为50.29%,发生MODS后病情严重程度及病死率和发生MODS的器官数目呈正相关,患者的年龄、病变部位靠近中线、格拉斯哥昏迷量表(GCS分值)、入院时意识状态、白细胞计数、入院24 h最高体温6项因素是高血压脑出血发生MODS的相关危险因素,病变部位靠近中线及基底动脉系统MODS的发生率高。结论高血压脑出血易引发MODS,尤以病灶面积较大、靠近中线多见;可以通过二级预防,降低其发病率及发展程度;通过发病早期对各项危险因素的检测,可了解患者的预后和转归,以便实施早期临床干预。

Objective：To study the incidence rate,the fatality rate and risk factors on multiple organ dysfunction syndrome （MODS） induced by hypertensive cerebral hemorrhage.Method：The clinic datas of 968 patients with hypertensive cerebral hemorrhage were studied by epidemiologie methods. Results： The incidence rate （IR） of MODS was 17.05%（169/968）, the death rate of MODS was 50.29%（85/169）,There were positive correlation between the disease severity and the numbers of dysfunction organs.The related risk factors included the age,the distance between the diseased region and the mean line, the GCS value,the conscious state on admission,the blood white cell count and the maximum body temperature in first 24 h. Conclusion：Hypertensive cerebral hemorrhage may induce MODS. Second level prevention could decrease the incidence rate and slow down the development of MODS. Early detection of risk factors of hypertension cerebral hemorrhage could provide the evaluation for the prognosis and turnover of patients and be helpful in the treatment of the disease.