原发性脑干出血预后影响因素研究

摘要

Objective To investigate influencing factors of prognosis in patients with primary brain stem hemorrhage. Methods A total of 80 patients with primary brain stem hemorrhage admitted to our hospital from October 2009 to October 2013 were selected,and they were divided into death group(n = 48)and survival group(n = 32)according to prognosis. Amount of bleeding,age,consciousness,respiratory,temperature and systolic pressure of the two groups were observed. Results The fatality rate was 60. 0% (48 / 80),the incidence of neurological function deficit in survival group was 62. 5% (20 / 32). A-mount of bleeding,age,Borg score,temperature and systolic pressure of death group were higher than those of survival group, while GCS score was lower(P < 0. 05). Linear - regression analysis results showed that,amount of bleeding,GCS score,Borg score,temperature,systolic pressure was correlated with poor prognosis of primary brain stem hemorrhage,respectively,and the regression equation was y = 5. 83 - 0. 18x( R2 = 0. 998),y = 25. 26 - 1. 25x( R2 = 0. 946),y = 2. 35 + 0. 31x( R2 =0. 984),y = 2. 38 - 0. 09x(R2 = 0. 996),y = 23. 44x(R2 = 0. 992),respectively. There was no linear - regression correla-tion between age and poor prognosis of primary brain stem hemorrhage. Conclusion Larger amount of bleeding,unconscious-ness,respiratory depression or failure,fever,hypertension were influencing factors of poor prognosis in patients with primary brain stem hemorrhage.%目的：探讨原发性脑干出血预后影响因素。方法选择我院2009年10月-2013年10月收治的原发性脑干出血患者80例，根据预后情况分为病死组48例和存活组32例，观察两组患者出血量、年龄、意识情况、呼吸情况、体温及收缩压。结果本组患者病死率为60.0%（48/80），存活患者神经功能缺损发生率为62.5%（20/32）。病死组患者出血量、年龄、Borg 评分、体温、收缩压高于存活组，格拉斯哥昏迷量表（ GCS）评分低于存活组（ P <0.05）。线性回归分析结果显示，出血量、GCS 评分、Borg 评分、体温、收缩压与原发性脑干出血预后差关系的回归方程分别为：y出血量=5.83-0.18x（ R2=0.998）、yGCS评分=25.26-1.25x（ R2=0.946）、yBorg评分=2.35+0.31x（ R2=0.984）、y体温=2.38-0.09x（R2=0.996）、y收缩压=23.44x（R2=0.992），而年龄与原发性脑干出血预后差无线性回归关系。结论大量出血、意识不清、呼吸抑制或呼吸衰竭、发热、高血压是导致原发性脑干出血患者预后差的重要原因。