發(fā)布時(shí)間：2018-08-04 08:41

【摘要】：目的:評(píng)估腦梗死復(fù)發(fā)患者可控危險(xiǎn)因素的自我管理情況及二級(jí)預(yù)防用藥(抗栓藥及他汀類)應(yīng)用現(xiàn)狀。啟發(fā)全科醫(yī)師對(duì)腦梗死患者的管理。方法:收集2016年6月1日至2016年11月31日廣西醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)內(nèi)科收治的符合納入標(biāo)準(zhǔn)的腦梗死復(fù)發(fā)患者92例,電話隨訪及醫(yī)院系統(tǒng)查閱住院資料及門診隨診記錄及處方,收集患者的年齡、性別、體重指數(shù)、糖尿病及高血壓病史、抗血小板及調(diào)脂治療,入院血壓、低密度脂蛋白、糖化血紅蛋白,記錄數(shù)據(jù),并運(yùn)用SPSS19.0軟件對(duì)所收集數(shù)據(jù)對(duì)進(jìn)行卡方檢驗(yàn)統(tǒng)計(jì)分析。利用單因素回歸模型,分析危險(xiǎn)因素與腦梗死復(fù)發(fā)的關(guān)系。結(jié)果:腦梗死復(fù)發(fā)患者平均年齡為67.2±10.4歲,其中男性67人,占72.8%。男性復(fù)發(fā)高峰為60歲~80歲,女性復(fù)發(fā)高峰為60~75歲。腦梗死患者可干預(yù)危險(xiǎn)因素(高血壓、糖尿病、血脂、吸煙)的自我管理較差。BMI、血脂控制欠佳、不規(guī)律服用抗血小板用藥與腦梗死復(fù)發(fā)時(shí)間正相關(guān)(P0.05)。正常體重與超重患者復(fù)發(fā)相比有顯著意義(P0.05),超重患者在第2年和第3年及以上的復(fù)發(fā)率高于正常體重患者,而在第1年則低于正常體重患者。血脂控制達(dá)標(biāo)、抗血小板規(guī)范用藥可延緩腦梗死的復(fù)發(fā)時(shí)間。結(jié)論:本研究中腦梗死患者可控危險(xiǎn)因素的自我管理能力,是影響腦梗死復(fù)發(fā)的主要因素之一;在可控危險(xiǎn)因素中,BMI、血脂控制達(dá)標(biāo)及抗血小板規(guī)范用藥可以延緩影響腦梗死復(fù)發(fā)。
[Abstract]:Objective: to evaluate the self-management of controllable risk factors in patients with recurrent cerebral infarction and the application of second-stage prophylaxis (anti-thrombus and statins). To inspire general practitioners to manage patients with cerebral infarction. Methods: from June 1, 2016 to November 31, 2016, 92 patients with recurrent cerebral infarction who were admitted to the Department of Neurology, first affiliated Hospital of Guangxi Medical University were collected. To collect age, sex, body mass index, diabetes and hypertension history, antiplatelet and lipid therapy, admission blood pressure, low density lipoprotein (LDL), and to collect age, sex, body mass index, history of diabetes and hypertension, admission blood pressure, low density lipoprotein (LDL). Glycosylated hemoglobin, record data, and use SPSS19.0 software to collect data pair for chi-square test statistical analysis. The single factor regression model was used to analyze the relationship between risk factors and recurrence of cerebral infarction. Results: the average age of patients with recurrent cerebral infarction was 67.2 鹵10.4 years old, 67 males (72.8%). The peak of recurrence was 60 to 80 years old in male and 60 to 75 years old in female. Patients with cerebral infarction may intervene in risk factors (hypertension, diabetes, blood lipids, smoking) poor self-management, poor control of blood lipids, irregular use of anti-platelet drugs and cerebral infarction recurrence time was positively correlated (P0.05). The recurrence rate of overweight patients in the second year and the third year and above was higher than that in the normal weight patients but in the first year it was lower than that in the normal weight patients. Blood lipids control standard, antiplatelet standard medication can delay the recurrence time of cerebral infarction. Conclusion: the self-management ability of controllable risk factors in patients with middle cerebral infarction is one of the main factors influencing the recurrence of cerebral infarction. Among the controllable risk factors, BMI, blood lipid control standard and antiplatelet standard can delay the recurrence of cerebral infarction.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.33

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