脑室外引流治疗脑室出血的预后相关因素研究
发布时间：2018-12-12 07:30
【摘要】：目的 回顾性分析脑室外引流(external ventricular drainage,EVD)治疗脑室出血(intraventricular hemorrhage,IVH)病例，，探讨影响其治疗预后的相关因素，并进一步研究明确各因素影响力的大小，将更好的治疗经验应用于临床工作中。 方法 选取60例吉林大学白求恩第二医院神经外一科2012年11月至2014年11月行脑室外引流治疗脑室出血的患者。以患者入院时的一般情况、临床表现、一般查体及神经系统专科查体、影像学资料、术后并发症等为自变量，以术后6个月患者的格拉斯哥预后评分(Glasgow Outcome Scale,GOS)（见附表1）评分为因变量，采用单因素分析，遴选出对预后有影响的因素。再使用多元线性回归方程进一步分析，得出以上有意义各因素对6个月预后的影响力。 结果 以患者入院时的一般情况、临床表现、一般查体及神经系统专科查体、影像学资料、术后并发症等为自变量，以术后6个月GOS为因变量，以上变量行单因素分析，所得有统计学意义的自变量为：继发性脑室出血脑实质血肿量、侧脑室及第三脑室血肿量、是否出现急性梗阻性脑积水、入院格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)（见附表2）、术后肺部感染、是否发生术后颅内感染及年龄。 通过多元线性逻辑回归方程显示，以上有意义的各因素为自变量，对我们所选取病例6个月的GOS影响力大小顺序依次为：侧脑室及第三脑室血肿量、继发性脑室出血中脑实质血肿量、入院时的GCS、是否发生急性脑积水、是否发生术后颅内感、术后肺部感染及年龄。 结论 影响脑室外引流治疗脑室出血预后的因素包括：脑实质血肿量、侧脑室及第三脑室血肿量、是否发生急性脑积水、GCS、术后肺部感染、是否发生术后颅内感染及年龄。 各因素对脑室外引流治疗脑室出血预后影响力大小循序为：侧脑室及第三脑室血肿量、继发性脑室出血中脑实质血肿量、患者入院GCS、是否发生急性脑积水、是否发生术后颅内感、术后肺部感染及年龄。
[Abstract]:Objective to analyze retrospectively the effect of ventricular drainage (external ventricular drainage,EVD) on ventricular hemorrhage (intraventricular hemorrhage,IVH), to explore the factors influencing the prognosis and to determine the influence of each factor. Better treatment experience will be applied to clinical work. Methods from November 2012 to November 2014, 60 patients with ventricular hemorrhage were treated with ventricular drainage in the Department of Neurology, Bethune second Hospital of Jilin University. Glasgow prognostic score (Glasgow prognostic score) of patients at 6 months after operation was based on the general condition, clinical manifestation, general physical examination and specialized physical examination of nervous system, imaging data, postoperative complications and so on. GOS) (see Table 1) as a dependent variable, univariate analysis was used to select the prognostic factors. The influence of the above factors on the prognosis of 6 months was obtained by further analysis of multiple linear regression equations. Results the patients' general condition, clinical manifestation, general physical examination and specialized examination of nervous system, imaging data and postoperative complications were taken as independent variables, and GOS was taken as dependent variable at 6 months after operation, and the above variables were analyzed by single factor analysis. The significant independent variables were: the amount of intracerebral parenchymal hematoma, the amount of hematoma in lateral ventricle and third ventricle, the presence of acute obstructive hydrocephalus and the admission to Glasgow coma score (Glasgow Coma Scale,GCS) (see Table 2). Postoperative pulmonary infection, whether postoperative intracranial infection and age. The multivariate linear regression equation showed that the above significant factors were independent variables, and the order of GOS influence for 6 months was as follows: the amount of hematomas in lateral ventricle and third ventricle. The amount of parenchyma hematoma in secondary ventricular hemorrhage, acute hydrocephalus occurred in GCS, at admission, postoperative intracranial sensation, postoperative pulmonary infection and age. Conclusion the factors influencing the prognosis of ventricular hemorrhage treated by ventricular drainage include the amount of hematoma in cerebral parenchyma, the amount of hematoma in lateral ventricle and third ventricle, the occurrence of acute hydrocephalus and pulmonary infection after GCS,. Whether the postoperative intracranial infection and age. The influence of various factors on the prognosis of ventricular hemorrhage was as follows: the amount of hematoma in lateral ventricle and third ventricle, the amount of parenchyma hematoma in secondary ventricular hemorrhage, whether acute hydrocephalus occurred in GCS,. Whether postoperative intracranial sensation, postoperative pulmonary infection and age.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1
本文编号：2374185
[Abstract]:Objective to analyze retrospectively the effect of ventricular drainage (external ventricular drainage,EVD) on ventricular hemorrhage (intraventricular hemorrhage,IVH), to explore the factors influencing the prognosis and to determine the influence of each factor. Better treatment experience will be applied to clinical work. Methods from November 2012 to November 2014, 60 patients with ventricular hemorrhage were treated with ventricular drainage in the Department of Neurology, Bethune second Hospital of Jilin University. Glasgow prognostic score (Glasgow prognostic score) of patients at 6 months after operation was based on the general condition, clinical manifestation, general physical examination and specialized physical examination of nervous system, imaging data, postoperative complications and so on. GOS) (see Table 1) as a dependent variable, univariate analysis was used to select the prognostic factors. The influence of the above factors on the prognosis of 6 months was obtained by further analysis of multiple linear regression equations. Results the patients' general condition, clinical manifestation, general physical examination and specialized examination of nervous system, imaging data and postoperative complications were taken as independent variables, and GOS was taken as dependent variable at 6 months after operation, and the above variables were analyzed by single factor analysis. The significant independent variables were: the amount of intracerebral parenchymal hematoma, the amount of hematoma in lateral ventricle and third ventricle, the presence of acute obstructive hydrocephalus and the admission to Glasgow coma score (Glasgow Coma Scale,GCS) (see Table 2). Postoperative pulmonary infection, whether postoperative intracranial infection and age. The multivariate linear regression equation showed that the above significant factors were independent variables, and the order of GOS influence for 6 months was as follows: the amount of hematomas in lateral ventricle and third ventricle. The amount of parenchyma hematoma in secondary ventricular hemorrhage, acute hydrocephalus occurred in GCS, at admission, postoperative intracranial sensation, postoperative pulmonary infection and age. Conclusion the factors influencing the prognosis of ventricular hemorrhage treated by ventricular drainage include the amount of hematoma in cerebral parenchyma, the amount of hematoma in lateral ventricle and third ventricle, the occurrence of acute hydrocephalus and pulmonary infection after GCS,. Whether the postoperative intracranial infection and age. The influence of various factors on the prognosis of ventricular hemorrhage was as follows: the amount of hematoma in lateral ventricle and third ventricle, the amount of parenchyma hematoma in secondary ventricular hemorrhage, whether acute hydrocephalus occurred in GCS,. Whether postoperative intracranial sensation, postoperative pulmonary infection and age.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1
【参考文献】
相关期刊论文 前4条
1 陈剑;脑出血后脑水肿病理机制的实验研究进展[J];国外医学.神经病学神经外科学分册;2001年05期
2 吴红记;潘勤;刘铁彪;王会岩;;基底节区脑出血破入脑室并发脑积水的手术治疗[J];中国实用神经疾病杂志;2011年24期
3 蔡利;王志勇;周毅;敖祥生;刘汉东;黄星;徐廷伟;胡克琦;张海泉;;经纵裂-胼胝体入路治疗脑室出血并急性脑积水[J];中国临床医学;2012年02期
4 唐超;薛洪利;;内皮素与创伤性脑水肿的相关性研究进展[J];沈阳部队医药;2004年06期
本文编号：2374185
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2374185.html
最近更新
教材专著
