大面积脑梗死患者生存风险因素分析

Analysis of survival risk factors of patients with large area cerebral infarction

目的探讨影响大面积脑梗死患者生存质量的危险因素。方法回顾性分析270例大面积脑梗死患者的临床资料,根据随访1a后是否存活分为2组,对比2组22项因素的差异,并对有统计学差异的因素进行Logistic回归分析。结果经单因素分析,2组年龄、发病到入院时间、是否首次脑梗死、是否合并糖尿病、心血管疾病、进展性脑卒中、脑疝、肺部感染、泌尿系感染、消化道出血以及是否接受去骨瓣减压术等方面比较差异有统计学意义(P<0.05或P<0.01);Logistic回归分析发现,既往脑梗死、合并进展性脑卒中、合并脑疝、合并泌尿系感染是影响大面积脑梗死患者预后的独立危险因素(P<0.05或P<0.01),而接受去骨瓣减压术则是保护性因素。结论积极治疗进展性脑卒中和泌尿系感染,并及时接受去骨瓣减压术可在一定程度上改善患者预后,降低生存风险。

Objective To investigate the survival risk factors of patients with large area cerebral infarction. Methods 270 patients with large area cerebral infarction were divided into the survival group and death group according to whether to live af -ter one year follow-up ,and the difference data between two groups were compared and analyzed by the logistic regression analy-sis. Results The age ,disease time ,first cerebral infarction or not ,diabetes mellitus ,cardiovascular disease ,progressing stroke ,cerebral hernia ,pulmonary infection ,urinary infection ,gastrointestinal bleeding and accepted bone disc decompression or not between two groups had significant difference by the single factor analysis ;The cerebral infarction history ,progressing stroke ,cerebral hernia ,urinary infection were independent hazard factors to patients with large area cerebral infarction ,but ac-cepted bone disc decompression was the protective factor of patients. Conclusion Treating the progressing stroke and urinary infection positively and accepting bone disc decompression timely can improve prognosis ,and reduce the survival risk of patients with large area cerebral infarction.