本文選題：高血壓腦出血 + 流行病學(xué)　； 參考：《石河子大學(xué)》2015年碩士論文

【摘要】：目的:本研究通過(guò)收集石河子市2012年1月至2013年12月高血壓腦出血患者的臨床病歷資料,分析石河子市高血壓腦出血的流行病學(xué)特征及短期預(yù)后相關(guān)因素。為石河子市高血壓腦出血提供客觀、科學(xué)的流行病學(xué)數(shù)據(jù)及預(yù)后相關(guān)因素,為對(duì)高血壓腦出血的預(yù)防、臨床干預(yù)、改善預(yù)后、提高臨床治愈率、降低致殘率及死亡率提供可靠的臨床試驗(yàn)依據(jù),更好地協(xié)助臨床預(yù)防和治療。方法:收集在石河子市人民醫(yī)院及石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院2012年1月至2013年12月新發(fā)并確診為高血壓腦出血患者373例,研究?jī)?nèi)容包括患者的一般情況、生活狀況、疾病史:高血壓、糖尿病、心臟病、發(fā)病情況、就診情況、入院時(shí)患者情況、入院后治療情況、治療結(jié)果及影響治療結(jié)果的其他因素;采用Epi Data 3.01進(jìn)行數(shù)據(jù)獨(dú)立雙份錄入。進(jìn)行一致性檢查和邏輯核查。對(duì)不一致和有錯(cuò)誤的內(nèi)容核對(duì)后,更新并鎖定數(shù)據(jù)庫(kù)。統(tǒng)計(jì)分析采用SPSS 17.0軟件,分類資料采用頻數(shù)(百分比)描述。組間率或構(gòu)成比的比較采用卡方檢驗(yàn)�；诙�(xiàng)分布,采用確切概率法估計(jì)率的95%CI。計(jì)量數(shù)據(jù)以均數(shù)?標(biāo)準(zhǔn)差(x?s)表示,計(jì)數(shù)資料以n形式表示,計(jì)量資料采用t檢驗(yàn),計(jì)數(shù)資料采用卡方檢驗(yàn)及方差分析,多因素分析采用Logistic多因素分析,均以P0.05為有統(tǒng)計(jì)學(xué)意義。結(jié)果:石河子市高血壓流行病學(xué)特征:2012年發(fā)病率為51.39/10萬(wàn),95%CI為44.12/10萬(wàn)~59.51/10萬(wàn);病死率為21.91%,95%CI為16.07%~28.71%。2013年發(fā)病率為55.67/10萬(wàn),95%CI為48.13/10萬(wàn)~64.05/10萬(wàn),病死率為21.54%,95%CI為15.99~27.98;新發(fā)高血壓腦出血患者以男性為主(62.43%);以50歲以上人群為主(91.15%);發(fā)病時(shí)段主要集中在06:00-18:00時(shí)(65.42%)。春秋兩季比例為57.37%。短期預(yù)后相關(guān)因素分析:304例患者中,共預(yù)后良好184例,預(yù)后不良120例,其中死亡31例。預(yù)后良好組與預(yù)后不良組在性別、高血壓(≥10年)、血糖(8mmol/L)、HICH知識(shí)知曉、血腫量、破入腦室、入院GCS評(píng)分、就診時(shí)間及肺部感染方面比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素Logistic分析顯示,性別、血腫量及入院GCS評(píng)分為高血壓腦出血短期預(yù)后的獨(dú)立影響因素。結(jié)論:1.石河子市HICH2012年、2013年的發(fā)病率分別為51.39/10萬(wàn)與55.69/10萬(wàn),病死率分別為21.91%與21.54%,發(fā)病率均在全國(guó)平均發(fā)病率范圍內(nèi),病死率低于全國(guó)平均水平。發(fā)病率呈上升趨勢(shì),病死率呈下降趨勢(shì)。統(tǒng)計(jì)學(xué)分析發(fā)現(xiàn)發(fā)病率之間、病死率之間無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.石河子市HICH發(fā)病人數(shù)在男性、41歲以上的中老年人,漢族,春季和秋季,3月及10月,6:00-18:00最多,發(fā)病至�？浦委煏r(shí)間3-12小時(shí)人數(shù)最多,統(tǒng)計(jì)學(xué)分析在發(fā)病年齡、民族、發(fā)病季節(jié)、發(fā)病時(shí)間,發(fā)病至�？浦委煏r(shí)間上存在差異,有統(tǒng)計(jì)學(xué)意義(P0.05),在性別、發(fā)病月份上無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.石河子市HICH預(yù)后因素分析結(jié)果在性別、高血壓(≥10年)、血糖(8mmol/L)、HICH知識(shí)知曉、血腫量、破入腦室、入院GCS評(píng)分、就診時(shí)間及肺部感染方面比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素Logistic分析顯示,性別、血腫量及入院GCS評(píng)分為HICH短期預(yù)后的獨(dú)立影響因素,臨床治療時(shí)應(yīng)密切注意上述指標(biāo),可改善患者的短期預(yù)后,降低HICH的病死率及致殘率。
[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.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 趙尖萍,史青平,任海蓉,杜麗萍,曲成毅;腦出血的危險(xiǎn)因素分析[J];中華神經(jīng)醫(yī)學(xué)雜志;2004年01期

2 汪國(guó)勝;鐘平;張雷;張蕾;馬爭(zhēng)飛;劉彬;;高血壓腦出血患者血清雌二醇、睪酮的變化及臨床意義[J];蚌埠醫(yī)學(xué)院學(xué)報(bào);2014年06期

3 高林;孫志紅;李欣舒;李勝華;;腦出血患者病死率與血壓相關(guān)性的研究[J];華西醫(yī)學(xué);2013年03期

4 崔琮琪;谷鑫;王海東;周脈耕;譚吉賓;;2006—2010年中國(guó)居民腦血管病死亡流行病學(xué)特征研究[J];疾病監(jiān)測(cè);2013年12期

5 單麗莉;;高血壓性腦出血死亡相關(guān)因素探討[J];中外醫(yī)療;2014年05期

6 呼鐵民;孫t畔，

本文編號(hào)：2080041