基层医院118例自发性脑出血近期常见并发症及其影响因素分析

Recent complications and its infl uencing factors of 118 patients with spontaneous intracerebral hemorrhage in primary hospital

目的:探索基层医院自发性脑出血患者住院近期各种并发症的相关危险因素。方法:回顾性分析118例自发性脑出血患者的常见并发症,对并发症可能危险因素进行Logistic回归分析。结果:118例自发性脑出血患者中,有103例(87.28%)存在各种不同的并发症,最常见并发症为血压升高(64.4%),其后依次为心律失常(31.4%)、高颅内压症(24.6%)、尿失禁(24.6%)、吞咽困难(21.2%)、肩手综合征(16.9%)、血糖升高(15.3%)、肺部感染(11.86%)等。二分类Logistic回归分析显示,入院后血压升高似与年龄组(X2)有相关;心律失常与出血是否破入脑室(X12)呈明显相关(P=0.029);高颅内压症与意识水平(X5)、出血量(X11)、出血破入脑室(X12)呈明显相关(P<0.05);尿失禁与意识水平(X5)呈相关危险因素(P<0.01);吞咽困难与意识水平(X5)、出血量(X11)呈明显相关危险因素(P<0.05)。结论:脑出血患者并发症发生率高,近年常见并发症为血压升高、高颅压症、心律失常、尿失禁、吞咽困难等。患者入院时意识水平、出血量大小、出血破入脑室分别是其综合危险因素。脑出血患者近期并发肩手综合征需要关注。

Objective： To explore the related risk factors of various complications in patients with spontaneous cerebral hemorrhage in primary hospital. Methods： a retrospective analysis of 118 cases of spontaneous intracerebral hemorrhage in patients with common complications, the incidence of complications of the possible risk factors for Logistic regression analysis. Results： 118 cases of spontaneous cerebral hemorrhage patients, 103 cases （ 87.28% ） had various complications, the most common complications as elevated blood pressure （64.4%）, followed by syndrome （ 16.9% ）, elevated blood sugar （ 15.3% ）, pulmonary infection （ 11.86% ）, arrhythmia （ 31.4% ）, high intracranial pressure syndrome （ 24.6% ）, urinary incontinence （ 24.6% ）, dysphagia （ 21.2% ）, shoulder hand syndrome. Binary logistic regression analysis showed that, after admission, elevated blood pressure and age group （ x2 ）, arrhythmia and hemorrhage breaking into ventricle （ X12 ） was significantly correlated （ P = 0. 029 ） ; high intracranial pressure symptoms and the level of awareness （ x5 ）, the amount of bleeding （ X11 ）, Hemorrhage Ruptured into cerebral ventricle （ X12 ） was significantly correlated （ P 〈 0.05 ） ; urinary incontinence and the level of awareness （ x5 ） was related risk factors （ P〈0.01 ） ; dysphagia and level of consciousness （ x5 ）, amount of bleeding （ X11 ） was significantly correlated risk factors （ P〈0.05 ）. Conclusion： the incidence rate of complications in patients with cerebral hemorrhage is high, the recent common complications such as high blood pressure, arrhythmia, high intracranial pressure, urinary incontinence, difficulty swallowing, etc.. Patients admitted to the hospital, the level of consciousness, the size of the amount of bleeding, bleeding into the ventricles are the comprehensive risk factors. The shoulder hand syndrome needs to pay attention to the patients with cerebral hemorrhage in the near future.