脑出血患者体温和白细胞的变化及其对预后影响

The prognostic influnence of temperature and leukocytes after intracerebral hemorrhage

目的:观察脑出血患者住院期间体温和白细胞的变化及对患者住院时间和院内死亡率的影响。方法:回顾性复习2011年1月至12月在我院住院的198例脑出血患者,登记白细胞计数和中性粒细胞比例、体温、感染并发症、住院时间和院内死亡率。结果:感染组白细胞异常、体温增高的发生率,住院时间和院内死亡率均高于非感染组(P<0.01),但两组体温升高持续时间无显著差异(P>0.01);无感染患者中,抗生素使用组和非使用组住院时间和院内死亡率无显著差异(P>0.05)。体温升高组的住院时间和院内死亡率均高于体温正常组(P<0.01),但非感染亚组体温升高并不增加死亡率(P>0.05)。白细胞异常组的住院时间和院内死亡率均高于正常组,非感染亚组结果相同(P<0.01)。结论:脑出血急性期以中性粒细胞为主的白细胞升高和体温增高较常见,但感染患者改变更明显;非感染患者预防使用抗生素不能改善患者预后。体温增高的患者预后较差,非感染患者的体温增高并不增加院内死亡率。白细胞总数和中性粒细胞比例升高的意义待进一步研究。

Objective ：To observe the change of temperature and leukoeytes in patients after intraeerebral hemorrhage （ICH） and the relationship of hospital stays and mortality. Methods： The retro-spective review of temperature, leukocytes, mortality and hospital stays on 198 inpatients with ICH （from January-December in 2011 ）. Results： Leukocytcs, temperature, mortality, and hospital stays were higher in infected group than non-infected group （P 〈 0. 01 ）, but the duration of high temperature of the two groups had no significant difference （ P 〉 0. 01 ） ; The hospital days and mortality had no significant difference between the antibiotic group and the non-antibiotic group in patients without infection （P 〉 0.05 ） ;The hospital stays and mortality were higher in patients with high temperature than those patients with normal temperature （P 〈 0.01 ）, At the the same time, however, hospital stays and mortality were also higher in patients with high leukocytes as compared to those patients with normal leukocytes （ P 〈 0.01 ）, but the non-infectious group with high tempera- ture did not increase mortality （ P 〉 0. 05 ）. Conclusion： Increased leukocytes, especially neutrophils, and high temperature in patients with cerebral hemorrhage are common. Antibiotics do not improve the ICH patients＇prognosis. Patients with hightemperature have poor prognosis, but those with high temperature without infection do not increase the mortality. The role of leukocytes has yet to be further studied.