西藏地区脑出血危险因素及预后10年趋势分析

Trend analysis of risk factors and prognosis of cerebral hemorrhage in Tibet in 10 years

目的：分析西藏高海拔地区过去10年脑出血的基本特征、危险因素及预后，并总结其治疗经验。方法以西藏军区总院2002～2012年收治的脑出血病例每5年分成一组，对前后二组临床资料进行对比分析。结果后5年组与前5年组对比，住院人数从2002～2007年的年均61例增加至2007～2012年的年均143例，男性比例从75％下降至66％，而女性比例从25％增加至34％（P＜0．01）；吸烟患者比例从38％下降至29％（P＜0．01），而应用降血压药物患者的比例从13％上升至27％（P＜0．01）；住院时间从21 d缩短至16 d（P＜0．05）。出院时的神经功能恢复情况应用改良Rankin量表（mRS）评价， mRS 0～3分的患者比例从43％上升至58％（P＜0．01），而mRS 4～5分的患者比例从46％下降至34％（P＜0．01）。结论虽然近年来西藏地区脑出血就诊人数增加，但总体呈现出预后改善的趋势，其原因可能与居民健康意识增强、医疗设备的改善和治疗方式的改进有关。

Objective To analyze the basic characteristics , risk factors and prognosis of cerebral hemorrhage in high-altitude area of Tibet in the last 10 years, and to summarize the therapeutic experience .Methods The patients with cerebral hemorrhage to receive treatment in General Hospital of Tibet Military Command from 2002 to 2012 were selected as the research subjects and divided into two groups per five years;and then, the clinical data in the two groups were compared and analyzed .Results According to the comparison between the two groups , the annual average number of the hospitalized people was 61 from 2002 to 2007, but it increased to 143 from 2007 to 2012, and the males decreased from 75% to 66%, while the females increased from 25% to 34% in the same periods （P＆lt;0.01）; the ratio of smoking patients decreased from 38% to 29% （P ＆lt;0.01）, and the ratio of application of antihypertensive drugs in patients increased from 13%to 27%（P＆lt;0.01）;the hospitalization period was shortened from 21d to 16 d （P＆lt;0.05）.Modified Rankin scale （mRS） was used to assess the recovery of neurological function , and the ratio of patients of mRS 0-3 increased from 43% to 58% （P ＆lt;0.01）, while that of mRS 4-5 decreased from 46% to 34% （P ＆lt;0.01）.Conclusion Although the number of patients with cerebral hemorrhage in Tibet has increased in recent years , the prognosis was improved overall;the reason maybe due to that the health consciousness of the residents , the medical equipment , and the methods of treatment have been improved.