急性脑血管疾病患者合并上消化道出血特点及防治探讨

Characteristics of Upper Gastrointestinal Bleeding in Patients With Acute Cerebral Vascular Disease and Its Prevention and Treatment

目的探讨急性脑血管疾病患者发生上消化道出血的特点及防治。方法选择40例急性脑血管疾病合并上消化道出血患者作为研究对象(观察组),按照1∶1比例选取同期急性脑卒中患者但未合并应激性溃疡出血40例作为对照组,比较两组患者的性别、年龄、应用糖皮质激素治疗、心理反应、GCS昏迷评分和禁食等差异;观察急性脑血管疾病患者上消化道出血治疗及预后,探讨预防措施。结果观察组中年龄≥70岁患者84.00%、应用糖皮质激素22.50%、存在不良心理反应60.00%、GCS评分<8分40.00%、禁食45.00%,分别高于对照组的65.00%、10.00%、30.00%、15.00%、12.50%(P<0.05)。观察组患者住院(22.57±4.56)d,死亡5例(12.50%,5/40)高于对照组的(15.09±2.47)d、0例(0.00%,0/40)(P<0.05)。结论急性脑血管疾病病程中容易发生上消化道出血,影响因素复杂、对预后有不良影响,要及时诊断合理治疗,并积极预防。

Objective To explore the characteristics and prevention of upper gastrointestinal bleeding in patients with acute cerebrovascular disease. Methods 40 patients Acute cerebral vascular disease in patients with upper as the research object（observation group）, according to the 1：1 ratio the same period 40 patients with acute cerebral stroke but not with gastrointestinal bleeding as the control group,compared two groups patients gender, age, use of glucocorticoid, psychological reaction, GCS coma score and fasting differences, observation of treatment and prognosis of gastrointestinal bleeding in patients with acute cerebrovascular disease of upper digestive, discuss preventive measures. Results The age of patients in the observation group ≥ 70 years old was 84.00%, glucocorticoids was 22.50%, have adverse psychological reactions 60.00%, GCS score〈 8 was 40.00%, fasting 45.00% higher than the control group 65.00%, 10.00%, 30.00%, 15.00%, 12.50%（P〈0.05）. Observation group patients were hospitalized（22.57±4.56） days, 5 cases death（12.50%, 5/40） higher than the control group（15.09±2.47） days, 0 cases（0%, 0/40）（P〈0.05）. Conclusion In the course of acute cerebral vascular disease, it is easy to occur on the digestive tract hemorrhage, the influencing factors are complex, have adverse effects on prognosis, should be timely diagnosis and reasonable treatment, and actively prevent.