青年脑卒中患者常规治疗预后的相关因素分析

Analysis of prognostic factors of young stroke patients with conventional treatment

目的 探讨影响青年脑卒中患者常规治疗预后的相关因素,为青年脑卒中患者的临床诊治提供依据.方法 回顾性分析72例行常规治疗的青年脑卒中患者的临床资料,对影响青年脑卒中患者常规治疗预后的相关因素进行分析.结果 72例青年脑卒中患者中经常规治疗无效18例（25.00％,18/72）,单因素分析结果显示年龄、吸烟、嗜酒、基础疾病、吞咽困难、Barthel指数（BI）评分、美国国立卫生研究院卒中量表（NIHSS）评分、牛津残障量表（OHS）评分与患者预后密切相关（P＜ 0.05或＜0.01）.多因素Logsitic回归分析结果显示年龄、BI评分、NIHSS评分、OHS评分、基础疾病是影响青年脑卒中患者预后的独立危险因素.18例常规治疗无效患者行综合康复训练,与康复训练前相比,患者康复训练1、3、6个月BI评分、NIHSS评分、OHS评分均显著下降,差异有统计学意义（P＜0.05）.结论 年龄、BI评分、NIHSS评分、OHS评分及基础疾病是影响青年脑卒中患者常规治疗无效预后的独立危险因素.对常规治疗无效的青年脑卒中患者行锥颅血肿清除治疗,术后进行综合性康复训练可提高疗效,有利于患者的预后.

Objective To investigate the prognostic factors of young stroke patients with conventional treatment, and provide the basis for clinical diagnosis and treatment of stroke. Methods The clinical data of 72 cases of young stroke patients with conventional treatment were analyzed retrospectively. The prognostic factors were analyzed. Results In seventy-two cases of young stroke patients, 18 cases of conventional treatment failed （25.00%, l 8/72 ）. Univariate analysis showed that smoking, alcohol, underlying disease, dysphagia,barthel index （BI） score,U.S, national institutes of health stroke scale （NIHSS） score and Oxford handicap scale （OHS） score was closely related with the prognosis （P〈 0.05 or 〈 0.01 ）. Logistic analysis showed that the age, BI score, NIHSS score, OHS score and underlying diseases was the independent prognostic factor for young stroke patients. Eighteen cases who failed in conventional treatment fails accepted comprehensive rehabilitation treatment. Compared with that before treatment, 1,3,6 months after treatment BI, NIHSS and OHS scores were significantly decreased （P 〈 0.05）. Conclusions BI, NIHSS, OHS score and underlying diseases are the independent prognostic factor for young stroke patients. Surgery and postoperative comprehensive rehabilitation in young stroke patients who failed in conventional treatment can improve patient＇ s outcomes and prognosis.