脑出血合并上消化道出血的危险因子分析

Analysis of the Relevant Risk Factors for Cerebral Hemorrhage Combined with Upper Gastrointestinal Bleeding

目的探讨影响脑出血合并上消化道出血的主要危险因素。方法采用回顾性分析法对112例脑出血患者进行总结,对合并上消化道出血的因素进行分析。结果发生急性上消化道出血46例(41.1%),与单纯脑出血组比较,发病年龄及性别差异无统计学意义(P>0.05)。在影响脑出血合并上消化道出血的相关因素中,上消化道出血的发生与脑出血量、出血部位、败血症、颅内压增高和GCS评分呈显著相关。Logistic回归分析表明,脑出血量、出血部位、败血症、颅内压增高和GCS评分是预测脑出血合并上消化道出血的风险因素。结论在脑出血的监护治疗中,应及时干预相关危险因素,降低消化道出血的发生,能够优先改善脑出血患者预后,降低病死率。

Objective To explore the major risk factors for cerebral hemorrhage combined with upper gastrointestinal（GI）bleeding.Methods The retrospective analytic method was adopted to summarize 112 cases of cerebral hemorrhage and analyze the factors for upper GI bleeding combined.Results 46 cases（41.1%）encountered the acute GI bleeding.As compared with the group of simple cerebral hemorrhage,the differences in the age and sex for the disease occurrence did not present statistical significance（P〉0.05）.Concerning to the relevant factors for cerebral hemorrhage and upper GI bleeding,the upper GI bleeding was significantly correlated with the volume of cerebral bleeding,the site of bleeding,septicemia,the elevation of intracranial pressure and GCS score.The results of Logistic regression analysis indicated that the volume of cerebral bleeding,the site of bleeding,septicemia,the elevation of intracranial pressure and GCS score were the risk factors for the prediction of cerebral hemorrhage combined with upper GI bleeding.Conclusion In the wardship of cerebral hemorrhage,the relevant risk factors should be intervened promptly to reduce the occurrence of GI bleeding,which enables to improve in priority the prognosis of cerebral hemorrhage and reduce the mortality.