持续性植物状态患者生存状况及其影响因素分析

发布时间：2018-05-02 07:19

  本文选题：持续植物人状态 + 预后　； 参考：《中国全科医学》2017年05期

【摘要】：目的探讨颅脑损伤后持续性植物状态(PVS)患者生存情况及预后相关因素。方法选取2009年1月—2014年6月在南华大学附属第二医院重症医学科入住的脑创伤及脑卒中的PVS患者196例,其中脑创伤108例,脑卒中88例。收集患者临床资料并对其进行随访,随访资料包括住院时间、营养方式、家庭经济情况、家庭照料情况、有无肺部感染、营养状况、生存状态等。分析患者的生存率,并采用Cox比例风险回归模型分析影响PVS患者预后的因素。结果 196例患者中位生存时间为12.5个月,1年生存率为53.5%,2年生存率为20.0%。不同性别、疾病类型者预后比较,差异无统计学意义(P0.05);不同年龄、住院时间、有无胃造口、家庭经济情况、家庭照料情况、有无肺部感染、营养状况者预后比较,差异均有统计学意义(P0.05)。多因素Cox比例风险回归模型分析结果显示,高龄、无胃造口、家庭照料情况差、有肺部感染、营养状况差是PVS患者预后不良的因素(P0.05)。按照预后不良因素数量,将患者分为2个预后不良因素者(n=109)和≥2个预后不良因素者(n=87),其中2个预后不良因素者中位生存时间为18.9个月,1年生存率为80.5%,2年生存率为30.0%;≥2个预后不良因素者中位生存时间为7.8个月,1年生存率为14.8%,2年生存率为0。两者1年、2年生存率比较,差异均有统计学意义(χ~2=92.781,P0.001;χ~2=26.073,P0.001)。结论约50.0%PVS患者在1年内死亡。高龄、无胃造口、家庭照料情况差、有肺部感染、营养状况差是PVS患者预后的独立不良因素。
[Abstract]:Objective to investigate the survival and prognostic factors of patients with persistent vegetative state PVS (PVS) after craniocerebral injury. Methods 196 patients with PVS were selected from January 2009 to June 2014 in the Department of intensive Medicine affiliated to the second affiliated Hospital of South China University, including 108 cases of brain trauma and 88 cases of stroke. The clinical data of the patients were collected and followed up. The follow-up data included hospital stay, nutritional style, family economic situation, family care, pulmonary infection, nutritional status, survival status and so on. The survival rate was analyzed and the prognostic factors of PVS patients were analyzed by Cox proportional risk regression model. Results the median survival time of 196 patients was 12.5 months, the 1-year survival rate was 53.5 and the 2-year survival rate was 20.0. There was no significant difference in the prognosis of patients with different sex and type of disease (P 0.05). The prognosis of patients with different age, length of stay, stomachstomy, family economic condition, family care, pulmonary infection and nutritional status were compared. The difference was statistically significant (P 0.05). The results of multivariate Cox proportional risk regression model showed that old age, no stomachstomy, poor family care, pulmonary infection and poor nutritional status were the factors of poor prognosis in patients with PVS. According to the number of prognostic factors, The patients were divided into 2 poor prognostic factors (n = 109) and 鈮，

本文编号：1832905