影响蛛网膜下腔出血再出血的危险因素分析及对策研究

Analysis of Risk Factors on Subarachnoid Hemorrhage and Rebleeding and Countermeasures

目的:分析蛛网膜下腔出血再出血的危险因素及干预对策,以期为临床提供借鉴。方法:回顾自2009年6月至2013年12月入我院诊断为蛛网膜下腔出血的患者为研究对象,对患者的一般情况,如性别、年龄、高血压、糖尿病、再出血季节、感染、激动情绪、吸烟、酗酒、便秘、咳嗽、运动过早或加剧等数据进行生存分析,评价蛛网膜下腔出血再出血的危险因素。结果:在我们观察的160患者中,年龄16-86岁,平均年龄46.5±16.5岁,男性共132例,女性28例,共有42例发生再出血。通过对患者众多情况的单因素logistic分析,感染、激动情绪、酗酒、便秘、年龄、高血压、咳嗽、冬季,P<0.05,将之纳入多因素分析。通过多因素非条件Logistic回归分析,激动情绪(P=0.000)、酗酒(P=0.002)、便秘(P=0.003)、年龄(P=0.000)、高血压(P=0.000)、咳嗽(P=0.000)为蛛网膜下腔出血再出血的危险因素。结论:激动情绪、酗酒、便秘、年龄、高血压、咳嗽为蛛网膜下腔出血再出血的危险因素。应注意情绪、饮酒、血压的控制、保持大便通畅,必要时应用镇咳药控制咳嗽。

Objective： To analyze the risk factors on subarachnoid hemorrhage and rebleeding and intervention countermeasures,in order to provide reference for clinic. Methods： 160 patients who diagnosed with subarachnoid hemorrhage from 2009.6 ~2013.12 in our hospital were selected as objects. The general situation of patients was analyzed, including gender, age, hypertension, diabetes,season of rebleeding, infection, mood, smoking, alcohol, constipation, cough, sports, and so on. to The risk factors on subarachnoid hemorrhage and rebleeding was evaluated. Results： In 160 cases of patients, there were 42 cases of rebleeding. Infection, emotion,alcoholism, constipation, age, hypertension, cough and winter was included in the multivariate analysis（P〈0.05）. Through logistic regression analysis on multiple factors, the emotion, alcoholism, constipation, age, hypertension and cough were the risk factors in subarachnoid hemorrhage and rebleeding. Conclusions： The excited emotion, alcoholism, constipation, age, hypertension and cough are the risk factors in subarachnoid hemorrhage and rebleeding. Patients with subarachnoid hemorrhage should pay attention to control of mood, alcohol and blood pressure, maintain defecate unobstructed, use cough medicine if necessary.