| 王建龙,曹利民,李红琴,裴静波.腑气通畅程度与急性脑出血患者近期临床转归的相关性研究[J].浙江中西医结合杂志,2015,25(8): |
| 腑气通畅程度与急性脑出血患者近期临床转归的相关性研究 |
| The correlation between bowel gas patency and recent clinical outcomes in patients with acute cerebral hemorrhage |
| 投稿时间：2014-12-15 修订日期：2015-06-10 |
| DOI： |
| 中文关键词: 脑出血 腑气通畅 危险因素 预后 |
| 英文关键词:Cerebral hemorrhage bowel gas patency risk factors prognosis |
| 基金项目:浙江省中医药(中西医结合)重点学科建设计划资助项目(No.2012-XK-D01)；杭州市卫生科技计划项目(No.2013B52)。 |
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| 中文摘要: |
| 目的 探讨腑气通畅程度与急性脑出血患者的近期临床转归的关系。方法 前瞻性连续纳入发病24小时内入院的自发性幕上脑出血患者。制定统一的资料收集表,收集人口统计学资料(年龄、性别)、血管危险因素(高血压、糖尿病、高脂血症、吸烟、饮酒)、入院时临床神经功能缺损评分(按照美国国立卫生院卒中量表(National institutes of Health Stroke Scale,NIHSS)、放射学资料(血肿部位、血肿体积)以及实验室检查结果(白细胞计数、血糖、血脂、C-反应蛋白)、发病后第一次排便时间、2周内排便次数。在发病后1个月应用改良Rankin量表(modified Rankin Scale,mRS)评价临床转归并分组,mRS评分≤2分定义为转归良好组,mRS评分≥3分定义为转归不良组。结果 研究期间共纳入113例急性脑出血患者,其中转归不良组68例(60.2%),转归良好组45例(39.8%)。单变量分析显示,转归不良组血肿体积[(26.67±7.94)cm3对(22.86±7.42) cm3；t=2.542,P=0.012)、NIHSS评分[(20.18±6.95)分对(16.02±6.62) 分；t=3.17,P=0.002)、白细胞数[(10.28±3.06)×109对(8.91±2.88) ×109；t=2.379,P=0.019)、空腹血糖[(8.45±1.73)mmol/L对(7.08±1.67) mmol/L；t=4.166,P=0.000)、甘油三酯[(2.26±0.97)mmol/L对(1.74±0.85) mmol/L；t=2.929,P=0.004)、C反应蛋白[(11.01±6.08)mg/L对(8.89±3.75) mg/L；t=2.096,P=0.038)、第一次排便时间[(33.87±15.14)小时对(24.33±8.69) 小时；t=3.825,P=0.000)显著高于转归良好组,2周内排便次数[(7.57±3.41)次对(10.62±2.44) 次；t=-5.175,P=0.000)显著低于转归良好组。多变量logistic回归分析显示,血肿体积较大[优势比(odds ratio,OR) 1.092, 95% 可信区间(confidence interval,CI)1.002～1.189;P =0.044]、第一次排便时间较长(OR 1.114,95%CI 1.008～1.221;P=0.000)是急性脑出血患者短期临床转归的独立预测因素。 |
| 英文摘要: |
| Objective To investigate the relationship between the bowel gas patency and recent clinical outcomes in patients with acute cerebral hemorrhage. Method Consecutive patients with spontaneous intracerebial hemorrhage admitted within 24 hours after onset were prospectively included. Formulate a unified data collection forms to collect demographic information data (age, gender), vascular risk factors (hypertension, diabetes, hyperlipidemia, smoking, drinking), admission clinical neurological deficit score according to the U.S. National Institutes of Health Stroke Scale, radiology information, (Hematoma location, hematoma volume), the test results of laboratory (white blood cell count, blood glucose, blood lipids, C-reactive protein), the frist defecation time after the occurrence of the disease and defecation frequency in two weeks.Modified Rankin Scale (mRS) was used to evaluate the clinical outcome in a month. The patients were divided into a good outcome group (mRS≤2) and poor outcome group (mRS≥3).Results A total of 113 patients with acute cerebral hemorrhage patients were included,with the poor outcome group 68 cases (60.2%) and the good outcome group of 45 patients (39.8%). |
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