本文選題：持續(xù)植物人狀態(tài) + 預(yù)后　； 參考：《中國全科醫(yī)學(xué)》2017年05期

【摘要】：目的探討顱腦損傷后持續(xù)性植物狀態(tài)(PVS)患者生存情況及預(yù)后相關(guān)因素。方法選取2009年1月—2014年6月在南華大學(xué)附屬第二醫(yī)院重癥醫(yī)學(xué)科入住的腦創(chuàng)傷及腦卒中的PVS患者196例,其中腦創(chuàng)傷108例,腦卒中88例。收集患者臨床資料并對(duì)其進(jìn)行隨訪,隨訪資料包括住院時(shí)間、營養(yǎng)方式、家庭經(jīng)濟(jì)情況、家庭照料情況、有無肺部感染、營養(yǎng)狀況、生存狀態(tài)等。分析患者的生存率,并采用Cox比例風(fēng)險(xiǎn)回歸模型分析影響PVS患者預(yù)后的因素。結(jié)果 196例患者中位生存時(shí)間為12.5個(gè)月,1年生存率為53.5%,2年生存率為20.0%。不同性別、疾病類型者預(yù)后比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);不同年齡、住院時(shí)間、有無胃造口、家庭經(jīng)濟(jì)情況、家庭照料情況、有無肺部感染、營養(yǎng)狀況者預(yù)后比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素Cox比例風(fēng)險(xiǎn)回歸模型分析結(jié)果顯示,高齡、無胃造口、家庭照料情況差、有肺部感染、營養(yǎng)狀況差是PVS患者預(yù)后不良的因素(P0.05)。按照預(yù)后不良因素?cái)?shù)量,將患者分為2個(gè)預(yù)后不良因素者(n=109)和≥2個(gè)預(yù)后不良因素者(n=87),其中2個(gè)預(yù)后不良因素者中位生存時(shí)間為18.9個(gè)月,1年生存率為80.5%,2年生存率為30.0%;≥2個(gè)預(yù)后不良因素者中位生存時(shí)間為7.8個(gè)月,1年生存率為14.8%,2年生存率為0。兩者1年、2年生存率比較,差異均有統(tǒng)計(jì)學(xué)意義(χ~2=92.781,P0.001;χ~2=26.073,P0.001)。結(jié)論約50.0%PVS患者在1年內(nèi)死亡。高齡、無胃造口、家庭照料情況差、有肺部感染、營養(yǎng)狀況差是PVS患者預(yù)后的獨(dú)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，

本文編號(hào)：1832905