石河子市高血压脑出血流行病学特征及预后相关因素研究

发布时间：2018-06-29 00:34

本文选题：高血压脑出血 + 流行病学　；参考：《石河子大学》2015年硕士论文

【摘要】：目的:本研究通过收集石河子市2012年1月至2013年12月高血压脑出血患者的临床病历资料,分析石河子市高血压脑出血的流行病学特征及短期预后相关因素。为石河子市高血压脑出血提供客观、科学的流行病学数据及预后相关因素,为对高血压脑出血的预防、临床干预、改善预后、提高临床治愈率、降低致残率及死亡率提供可靠的临床试验依据,更好地协助临床预防和治疗。方法:收集在石河子市人民医院及石河子大学医学院第一附属医院2012年1月至2013年12月新发并确诊为高血压脑出血患者373例,研究内容包括患者的一般情况、生活状况、疾病史:高血压、糖尿病、心脏病、发病情况、就诊情况、入院时患者情况、入院后治疗情况、治疗结果及影响治疗结果的其他因素;采用Epi Data 3.01进行数据独立双份录入。进行一致性检查和逻辑核查。对不一致和有错误的内容核对后,更新并锁定数据库。统计分析采用SPSS 17.0软件,分类资料采用频数(百分比)描述。组间率或构成比的比较采用卡方检验。基于二项分布,采用确切概率法估计率的95%CI。计量数据以均数?标准差(x?s)表示,计数资料以n形式表示,计量资料采用t检验,计数资料采用卡方检验及方差分析,多因素分析采用Logistic多因素分析,均以P0.05为有统计学意义。结果:石河子市高血压流行病学特征:2012年发病率为51.39/10万,95%CI为44.12/10万~59.51/10万;病死率为21.91%,95%CI为16.07%~28.71%。2013年发病率为55.67/10万,95%CI为48.13/10万~64.05/10万,病死率为21.54%,95%CI为15.99~27.98;新发高血压脑出血患者以男性为主(62.43%);以50岁以上人群为主(91.15%);发病时段主要集中在06:00-18:00时(65.42%)。春秋两季比例为57.37%。短期预后相关因素分析:304例患者中,共预后良好184例,预后不良120例,其中死亡31例。预后良好组与预后不良组在性别、高血压(≥10年)、血糖(8mmol/L)、HICH知识知晓、血肿量、破入脑室、入院GCS评分、就诊时间及肺部感染方面比较差异具有统计学意义(P0.05)。多因素Logistic分析显示,性别、血肿量及入院GCS评分为高血压脑出血短期预后的独立影响因素。结论:1.石河子市HICH2012年、2013年的发病率分别为51.39/10万与55.69/10万,病死率分别为21.91%与21.54%,发病率均在全国平均发病率范围内,病死率低于全国平均水平。发病率呈上升趋势,病死率呈下降趋势。统计学分析发现发病率之间、病死率之间无统计学意义(P0.05)。2.石河子市HICH发病人数在男性、41岁以上的中老年人,汉族,春季和秋季,3月及10月,6:00-18:00最多,发病至专科治疗时间3-12小时人数最多,统计学分析在发病年龄、民族、发病季节、发病时间,发病至专科治疗时间上存在差异,有统计学意义(P0.05),在性别、发病月份上无统计学意义(P0.05)。3.石河子市HICH预后因素分析结果在性别、高血压(≥10年)、血糖(8mmol/L)、HICH知识知晓、血肿量、破入脑室、入院GCS评分、就诊时间及肺部感染方面比较差异具有统计学意义(P0.05)。多因素Logistic分析显示,性别、血肿量及入院GCS评分为HICH短期预后的独立影响因素,临床治疗时应密切注意上述指标,可改善患者的短期预后,降低HICH的病死率及致残率。
[Abstract]:Objective: to analyze the epidemiological characteristics of hypertensive cerebral hemorrhage in Shihezi and the related factors of short-term prognosis by collecting the clinical data of hypertensive cerebral hemorrhage in Shihezi from January 2012 to December 2013, and to provide objective, scientific epidemiological data and prognostic factors for hypertensive cerebral hemorrhage in Shihezi. The prevention of hypertensive intracerebral hemorrhage, clinical intervention, improving the prognosis, improving the clinical cure rate, reducing the rate of disability and mortality provide a reliable clinical trial basis, and better assist in clinical prevention and treatment. Methods: a new method was collected at the Shihezi people's Hospital and the First Affiliated Hospital of the medical College of Shihezi University from January 2012 to December 2013. 373 cases of hypertensive intracerebral hemorrhage were diagnosed, including general situation, living condition, history of disease: hypertension, diabetes, heart disease, disease, medical condition, hospitalization, treatment, treatment results and other factors affecting the outcome of treatment; Epi Data 3.01 was used for data independent double entry. Conduct consistency check and logical verification. After checking inconsistent and wrong content, update and lock up the database. Statistical analysis uses SPSS 17 software, classification data is described by frequency (percentage). The comparison of inter group rate or composition ratio uses chi square test. Based on the two distribution, the 95%CI. measurement of the exact probability estimation rate is adopted. According to the average number? Standard deviation (x? S), the count data were expressed in the form of N, the measurement data were t test, the counting data were analyzed by chi square test and variance analysis, and the multifactor analysis was analyzed with Logistic multiple factors. The statistical significance was P0.05. The epidemiological characteristics of high blood pressure in Shihezi were: the incidence rate of 2012 was 51.39/10 million, 95%CI was The mortality rate of 44.12/10 was 21.91%, the mortality rate was 21.91%, the incidence of 16.07%~28.71%.2013 was 55.67/10 million, 95%CI was 48.13/10 million ~64.05/10 million, the mortality rate was 21.54%, and 95%CI was 15.99~27.98; the patients with new hypertensive intracerebral hemorrhage were mainly male (62.43%), and the population above 50 years old (91.15%); the onset time period mainly concentrated at 06:00-18:00 (6). 5.42%) analysis of the relative factors of 57.37%. short-term prognosis in the spring and Autumn period and two quarter: of the 304 patients, there were 184 cases of good prognosis and 120 cases of poor prognosis, of which 31 died. The good prognosis group and poor prognosis group were sex, hypertension (> 10 years), blood glucose (8mmol/L), HICH knowledge, hematoma volume, broken into the ventricle, admission GCS score, visiting time and lung The difference of infection was statistically significant (P0.05). Multiple factor Logistic analysis showed that gender, hematoma and admission GCS score were independent factors for short-term prognosis of hypertensive intracerebral hemorrhage. Conclusion: 1. Shihezi city HICH2012, the incidence of 2013 was 51.39/10 million and 55.69/10 million, and the mortality rate was 21.91% and 21.54%, respectively. The morbidity was lower than the national average. The incidence was on the rise and the mortality rate was declining. Statistical analysis found that there was no statistical significance between the incidence and the mortality rate (P0.05).2. in Shihezi City, the number of HICH in male, Han, Han, spring and autumn, March and In October, the largest number of 6:00-18:00, 3-12 hours of disease to specialist treatment time is the most, statistical analysis in the onset of age, ethnic, onset season, onset time, onset to special treatment time, there are statistical significance (P0.05), there is no statistical significance (P0.05) in the month of disease (P0.05).3. Shihezi city HICH prognostic factors analysis results. In sex, hypertension (more than 10 years), blood glucose (8mmol/L), knowledge of HICH knowledge, hematoma, broken into the ventricle, admission to the GCS score, the time for hospitalization and pulmonary infection, the difference was statistically significant (P0.05). Multiple factor Logistic analysis showed that sex, hematoma and admission GCS score were independent factors of short-term prognosis of HICH, and the clinical treatment should be used. Paying close attention to the above indicators can improve the short-term prognosis and reduce the mortality and disability rate of HICH.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1

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