腦室外引流治療腦室出血的預(yù)后相關(guān)因素研究
發(fā)布時(shí)間：2018-12-12 07:30
【摘要】：目的 回顧性分析腦室外引流(external ventricular drainage,EVD)治療腦室出血(intraventricular hemorrhage,IVH)病例，，探討影響其治療預(yù)后的相關(guān)因素，并進(jìn)一步研究明確各因素影響力的大小，將更好的治療經(jīng)驗(yàn)應(yīng)用于臨床工作中。 方法 選取60例吉林大學(xué)白求恩第二醫(yī)院神經(jīng)外一科2012年11月至2014年11月行腦室外引流治療腦室出血的患者。以患者入院時(shí)的一般情況、臨床表現(xiàn)、一般查體及神經(jīng)系統(tǒng)專科查體、影像學(xué)資料、術(shù)后并發(fā)癥等為自變量，以術(shù)后6個(gè)月患者的格拉斯哥預(yù)后評(píng)分(Glasgow Outcome Scale,GOS)（見附表1）評(píng)分為因變量，采用單因素分析，遴選出對(duì)預(yù)后有影響的因素。再使用多元線性回歸方程進(jìn)一步分析，得出以上有意義各因素對(duì)6個(gè)月預(yù)后的影響力。 結(jié)果 以患者入院時(shí)的一般情況、臨床表現(xiàn)、一般查體及神經(jīng)系統(tǒng)�？撇轶w、影像學(xué)資料、術(shù)后并發(fā)癥等為自變量，以術(shù)后6個(gè)月GOS為因變量，以上變量行單因素分析，所得有統(tǒng)計(jì)學(xué)意義的自變量為：繼發(fā)性腦室出血腦實(shí)質(zhì)血腫量、側(cè)腦室及第三腦室血腫量、是否出現(xiàn)急性梗阻性腦積水、入院格拉斯哥昏迷評(píng)分(Glasgow Coma Scale,GCS)（見附表2）、術(shù)后肺部感染、是否發(fā)生術(shù)后顱內(nèi)感染及年齡。 通過多元線性邏輯回歸方程顯示，以上有意義的各因素為自變量，對(duì)我們所選取病例6個(gè)月的GOS影響力大小順序依次為：側(cè)腦室及第三腦室血腫量、繼發(fā)性腦室出血中腦實(shí)質(zhì)血腫量、入院時(shí)的GCS、是否發(fā)生急性腦積水、是否發(fā)生術(shù)后顱內(nèi)感、術(shù)后肺部感染及年齡。 結(jié)論 影響腦室外引流治療腦室出血預(yù)后的因素包括：腦實(shí)質(zhì)血腫量、側(cè)腦室及第三腦室血腫量、是否發(fā)生急性腦積水、GCS、術(shù)后肺部感染、是否發(fā)生術(shù)后顱內(nèi)感染及年齡。 各因素對(duì)腦室外引流治療腦室出血預(yù)后影響力大小循序?yàn)椋簜?cè)腦室及第三腦室血腫量、繼發(fā)性腦室出血中腦實(shí)質(zhì)血腫量、患者入院GCS、是否發(fā)生急性腦積水、是否發(fā)生術(shù)后顱內(nèi)感、術(shù)后肺部感染及年齡。
[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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.1
本文編號(hào)：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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.1
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