脑血管意外的临床转归及影响因素研究

发布时间：2018-04-15 13:22

本文选题：脑血管意外 + 临床转归　；参考：《中南大学》2014年硕士论文

【摘要】：目的：研究脑血管意外的临床转归及影响因素,为卫生行政部门对脑血管意外的卫生资源和费用投入,临床科室制定治疗方针、控制住院时间和医疗费用、康复指导、健康教育提供依据。方法：收集中南大学湘雅三医院2008～2013年所有脑血管意外住院患者病案首页资料,主要内容包括人口统计学信息、疾病特征、治疗情况和卫生经济学指标信息等,分析脑血管意外的临床转归及影响因素。统计分析采用SPSS13.0软件进行分析。计数资料的比较用x2检验、非参数的秩和检验,影响因素的筛选采用Logistic回归分析。结果： 1.本研究共纳入脑血管意外住院患者8826例,其中男性5348人,女性3478人。年龄最小为1岁,最大为101岁,中位数为63岁。70.3%的病例诊断为缺血性脑血管意外,29.7%诊断为出血性脑血管意外,其中23.6%诊断为脑出血,6.1%诊断为蛛网膜下腔出血。 2.研究对象的治愈率为3%,病死率为0.8%,多数为好转93.7%,未愈率为2.6%。其中缺血性脑血管意外治愈率为1.7%,好转率为96.8%,未愈率为1.2%,病死率为0.3%；出血性脑血管意外的治愈率为6.0%,好转率为86.3%,未愈率为5.9%,病死率为1.9%。 3.多因素分析结果显示：对全部脑血管意外病人而言,未实施过手术、缺血性脑血管意外、住院时间长,则转归较好；对缺血性脑血管意外的病人而言,未实施过手术、住院时间长、住院次数少的病人转归较好；对出血性脑血管意外的病人而言,未实施过手术、住院时间长的病人转归较好。结论： 1.脑血管意外的治愈率为3%,病死率为0.8%,多数为好转93.7%,未愈率为2.6%。 2.对全部脑血管意外病人而言,未实施过手术、缺血性脑血管意外、住院时间长,则转归较好；对缺血性脑血管意外的病人而言,未实施过手术、住院时间长、住院次数少的病人转归较好；对出血性脑血管意外的病人而言,未实施过手术、住院时间长的病人转归较好。
[Abstract]:Objective:To study the clinical outcome and influencing factors of cerebrovascular accident, to input the health resources and expenses of health administrative department to cerebrovascular accident, to formulate the treatment policy, to control the length of stay and medical expenses, and to guide rehabilitation.Provide basis for health education.Methods:Collect the first page data of all the inpatients with cerebrovascular accident from 2008 to 2013 in Xiangya No.3 Hospital of Central South University. The main contents include demographic information, disease characteristics, treatment situation and health economics index information, etc.To analyze the clinical outcome and influencing factors of cerebrovascular accident.The statistical analysis was carried out by SPSS13.0 software.The count data were compared by x2 test, nonparametric rank sum test and Logistic regression analysis.Results:1.The study included 8826 inpatients with cerebrovascular accident, including 5348 males and 3478 females.The minimum age was 1 year old, the maximum was 101 years old, the median was 63 years old. 70.3% of the cases were diagnosed as ischemic cerebrovascular accident 29. 7% of them were diagnosed as hemorrhagic cerebrovascular accident, and 23. 6% of them were diagnosed as cerebral hemorrhage and 6. 1% of them were diagnosed as subarachnoid hemorrhage.2.The cure rate of the subjects was 3 and the mortality was 0.8. Most of them were improved 93.7and the uncured rate was 2.6.The cure rate of ischemic cerebrovascular accident was 1.7%, the improvement rate was 96.8%, the uncured rate was 1.2 and the mortality rate was 0.3%, the cure rate of hemorrhagic cerebrovascular accident was 6.0%, the improvement rate was 86.3%, the uncured rate was 5.9%, the mortality rate was 1.9 points.3.The results of multivariate analysis showed that, for all patients with cerebrovascular accident, no operation had been performed, the patients with ischemic cerebrovascular accident had long hospital stay, and the patients with ischemic cerebrovascular accident had not had an operation.For the patients with hemorrhagic cerebrovascular accident, the patients who had not been operated on and the patients who had been hospitalized for a long time were better.Conclusion:1.The cure rate of cerebrovascular accident was 3 and the fatality rate was 0.8. Most of them were improved 93.7and the uncured rate was 2.6.2.For all patients with cerebrovascular accident, no operation has been performed, and the duration of hospitalization for ischemic cerebrovascular accident is longer. For patients with ischemic cerebrovascular accident, no operation has been performed and the hospital stay is long.For the patients with hemorrhagic cerebrovascular accident, the patients who had not been operated on and the patients who had been in hospital for a long time had a better outcome.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

【参考文献】