摘要
目的探索未静脉溶栓的急性缺血性脑卒中患者出血并发症的相关危险因素及对预后的影响,以期有效地病情观察和临床干预,改善预后,提供指导依据。方法通过某院HIS系统选取2022年1月1日-2022年12月31日于神经内科和神经外科住院治疗的急性缺血性脑卒中患者,共纳入119例,调取住院病案首页及病案中的人口学特征、实验室指标、既往史、合并症、治疗操作和临床预后结果,以及NIHSS评分和GCS评分等数据。根据单因素分析和多因素logistic回归分析探索其出血并发症的危险因素。结果将119例急性缺血性脑卒中患者按照是否发生出血转化分为出血组37例,占31.1%;未出血组82例,占68.9%。单因素分析结果年龄、高血压、心房颤动、消化道疾病、饮酒、败血症、机械通气、NIHSS评分、血红蛋白、住院时间、住院费用、死亡比例,差异有统计学意义,P<0.05。多因素Logistic回归分析示年龄、高血压、心房颤动、NIHSS评分是急性缺血性脑卒中患者发生出血转化的独立危险因素,P<0.05。结论急性缺血性脑卒中未静脉溶栓的患者是出血并发症的高危人群,高龄、高血压、心房颤动、NIHSS是并发出血的独立危险因素。可以通过预警识别危险因素,从而及时有效地进行病情观察和护理干预,以期改善患者预后。
Objectives To explore the risk factors related to bleeding complications in acute ischemic stroke patients without intravenous thrombolysis and its influence on prognosis,in order to provide guidance for timely and effective observation and clinical intervention,and improve prognosis.Methods A total of 119 patients with acute ischemic stroke who were hospitalized in the department of neurology and neurosurgery from January 1st,2022 to December 31st,2022 were enrolled through HIS system of a hospital,and demographic characteristics,laboratory indicators,past history,comorbidities,treatment operations and clinical prognosis results were obtained from the front page of hospitalization medical records and medical records.And NIHSS score and GCS score and other data.The risk factors of bleeding complications were investigated by univariate analysis and multivariate logistic regression analysis.Results 119 patients with acute ischemic stroke were divided into the hemorrhage group(37 cases,31.1%)according to whether bleeding transformation occurred.There were 82 cases(68.9%)without bleeding.There were statistically significant differences in age,hypertension,atrial fibrillation,digestive tract diseases,alcohol consumption,sepsis,mechanical ventilation,NIHSS score,hemoglobin,length of stay,hospitalization cost,and mortality ratio,P<0.05.Multiple logistic regression analysis showed that age,hypertension,atrial fibrillation and NIHSS score were independent risk factors for bleeding transformation in patients with acute ischemic stroke,P<0.05.Conclusions Patients with acute severe ischemic stroke were at high risk of hemorrhage complications.Old age,hypertension,atrial fibrillation and NIHSS were independent risk factors for complication of hemorrhage.Risk factors could be identified through early warning,so as to carry out timely and effective observation and nursing intervention,in order to improve the prognosis of patients.
作者
李晓宏
王颖
陶香君
李锦平
Li Xiaohong;Wang Ying;Tao Xiangjun;Li Jinping(Department of Neurology,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China;不详)
出处
《中国病案》
2024年第12期103-105,共3页
Chinese Medical Record
关键词
缺血性脑卒中
出血转化
影响因素
未静脉溶栓
Ischemic stroke
Bleeding transformation
Influencing factors
No intravenous thrombolysis
