急性脑卒中并发上消化道出血的危险因素及预后分析

Risk Factors and Prognosis Analysis of Patients with Acute Stroke Complicated to Upper Gastrointestinal Hemorrhage

目的:分析急性脑卒中并发上消化道出血的相关危险因素及其对预后的影响。方法:将2011年1月—2013年12月收治的急性脑卒中患者563例分别按缺血性脑卒中与出血性脑卒中,有无意识障碍,有无脑疝各分为两组,分别比较其上消化道出血发生率;按有无并发上消化道出血分为两组,比较两组间GCS评分、肺炎发生率、MODS发生率以及病死率。结果:出血性脑卒中上消化道出血发生率高于缺血性脑卒中;意识障碍组上消化道出血发生率高于非意识障碍组;并发脑疝组上消化道出血发生率高于非并发脑疝组;脑卒中伴上消化道出血组GCS评分低于无伴上消化道出血组;脑卒中伴上消化道出血组肺炎发生率、MODS发生率以及病死率均明显高于无伴上消化道出血组(P<0.01)。结论:并发上消化道出血是急性脑卒中病情危重的一个独立因素,且其预后差。

Objective ：To analyze the risk factors and prognosis in patients with acute stroke complicated to upper gastrointestinal hemorrhage. Methods ：563 patients with acute stroke were divided into two groups respectively according to ischemic stroke or hemorrhagic stroke, consciousness disorders or no,and cerebral hernia or no from Jan2011 to Dec 2013. The incidence rate of upper gastrointestinal hemorrhage was compared between every two groups.In the mean time,we divided all the patients into two groups according to cases complicated with upper gastrointestinal hemorrhage or no and compared their GCS score, incidence rate of pneumonia, incidence rate of MODS and fatality rate. Results ：The incidence rates of upper gastrointestinal hemorrhage in the groups of hemorrhagic stroke, consciousness disorders and cerebral hernia were higher than their respective control groups. The GCS score in the group complicated with upper gastrointestinal hemorrhage was lower than the control group. The incidence rate of pneumonia, incidence rate of MODS and fatality rate in the group complicated with upper gastrointestinal hemorrhage were higher than their respective control groups, all P〈0.01. Conclusion ： Complicated with upper gastrointestinal hemorrhage or no was an independent risk factor in acute stroke and it is a bad prognosis.