缺血性脑卒中患者静脉溶栓后出血转化的危险因素分析及护理干预

Analysis of Risk Factors for Hemorrhage Transformation After Intravenous Thrombolysis in Patients withIschemic Stroke and Nursing Intervention

目的综合分析缺血性脑卒中患者静脉溶栓后出血转化的危险因素及护理干预。方法选取本院在2018年2月至2019年1月收治的83例缺血性脑卒中患者,根据其有无发生出血转化分为出血转化组(23例)、非出血转化组(60例)。采用统计学分析出血转化组、非出血转化组的一般资料、实验室有关检测指标等,进行单因素和Logistic多因素分析危险因素。结果单因素分析显示:出血转化组年龄、心房颤动、神经功能缺损评分、溶栓前血浆凝血酶原时间、吸烟史、服用抗凝药、高血压史、清蛋白、肾小球滤过率估计值与非出血转化组比较差异有统计学意义(P<0.05);Logistic多因素分析:显示年龄、心房颤动、神经功能缺损评分、溶栓前血浆凝血酶原时间、清蛋白、肾小球滤过率估计值、服用抗凝药、高血压史、吸烟史是缺血性脑卒中患者静脉溶栓后出血的危险因素(P<0.05)。结论根据缺血性脑卒中患者静脉溶栓后出血转化的危险因素,可提供针对性护理护理干预措施。

Objective To comprehensively analyze the risk factors and nursing intervention of hemorrhage transformation in patients with ischemic stroke after intravenous thrombolysis.Methods A total of 83 patients with ischemic stroke admitted to our hospital from February 2018 to January 2019 were selected and divided into hemorrhagic transformation group(23 cases)and non-hemorrhagic transformation group(60 cases)according to whether they had hemorrhagic transformation.).Statistical analysis was used to analyze the general data of the hemorrhage transformation group and the non-hemorrhage transformation group,relevant laboratory test indicators,etc.,single factor and logistic multivariate analysis of risk factors.Results Univariate analysis showed that age,atrial fibrillation,neurological deficit score,prothrombin time before thrombolysis,history of smoking,anticoagulant medication,history of hypertension,albumin,and estimated values of glomerular filtration rate in the hemorrhage transformation group The difference between the non-hemorrhage transformation group was statistically significant(P<0.05);Logistic multivariate analysis showed age,atrial fibrillation,neurological deficit score,prethrombolytic plasma prothrombin time,albumin,and glomerular filtration rate estimation The risk factors for bleeding after intravenous thrombolysis in patients with ischemic stroke(P<0.05)are the risk factors of blood pressure,anticoagulant drugs,history of hypertension,and smoking history.Conclusion According to the risk factors of hemorrhage transformation after intravenous thrombolysis in patients with ischemic stroke,targeted nursing intervention measures can be provided.