高血压合并脑出血84例临床分析

目的:掌握高血压合并脑出血患者的临床特点,有效的预防脑出血的发生,提高治愈率,减少病死率、致残率。方法:将84例患高血压合并脑出血的患者进行临床分析。结果:患病年龄在34岁～77岁,平均年龄57.7岁;死亡33例,病死率为39.3%,病死率与年龄成正比。结论:脑出血是高血压病最常见的并发症之一,并有高致残率和高病死率,避免脑出血发生的主要措施是防治高血压病。     

118例高血压性脑出血的临床分析

目的 掌握高血压合并脑出血患者的临床特点,有效的预防脑出血的发生,提高治愈率,减少病死率.方法 将118例患高血压合并脑出血的患者的临床资料进行临床分析.结果 患病高发年龄40～70岁,平均61岁;死亡67例,占56.77%,病死率与年龄成正比.结论 脑出血是高血压病最常见的并发症之一,并有高致残率和高病死率,避免脑出血的发生主要措施是防治高血压病.     

高血压合并脑出血168例临床分析

目的:掌握高血压合并脑出血患者的临床特点,有效的预防脑出血的发生,提高治愈率,减小病死率。方法:对2003年至2006年在我院住院168例患高血压合并脑出血的患者进行临床分析。结果:高发年龄在50岁～70岁,平均年龄58.2岁,死亡69例,占41.09%。病死率与年龄成正比,脑出血急性期的高病死率与脑出血继续出血有关。结论:脑出血是高血压病最常见的并发症之一,并有高致残率和高病死率,避免脑出血的发生主要措施是防治高血压。     

高血压合并脑出血68例疗效分析

目的 掌握高血压合并脑出血患者的临床特点,提高治愈率,减少病死率.方法 回顾性分析68例患高血压合并脑出血的患者的临床资料.结果 患病高发年龄在42-63岁,平均年龄55岁;死亡12例,占17.65%,病死率与年龄成正比.结论 脑出血是高血压病最常见的并发症之一,致残率和死亡率高,预防脑出血发生的主要措施是早期有效地防治高血压病.     

高血压合并脑出血168例临床分析

目的：掌握高血压合并脑出血患者的临床特点，有效的预防脑出血的发生，提高治愈率，减小病死率。方法：对2003年至2006年在我院住院168例患高血压合并脑出血的患者进行临床分析。结果：高发年龄在50岁-70岁，平均年龄58．2岁，死亡69例，占41．09％。病死率与年龄成正比，脑出血急性期的高病死率与脑出血继续出血有关。结论：脑出血是高血压病最常见的并发症之一，并有高致残率和高病死率，避免脑出血的发生主要措施是防治高血压。     

高血压合并脑出血160例临床分析

目的 掌握高血压合并脑出血病人的临床特点,有效的预防脑出血的发生,提高治愈率,减少病死率.方法 将160例患高血压合并脑出血的病人进行临床分析.结果 患病高发年龄在48～58 岁,平均年龄57.9岁;死亡65例,占40.6%,病死率与年龄成正比.结论 脑出血是高血压病最常见的并发症之一,并有高致残率和高死亡率,避免脑出血发生的主要措施是防治高血压病.     

高血压合并脑出血160例临床分析

目的 掌握高血压合并脑出血病人的临床特点,有效的预防脑出血的发生,提高治愈率,减少病死率.方法 将160例患高血压合并脑出血的病人进行临床分析.结果 患病高发年龄在48～58 岁,平均年龄57.9岁;死亡65例,占40.6%,病死率与年龄成正比.结论 脑出血是高血压病最常见的并发症之一,并有高致残率和高死亡率,避免脑出血发生的主要措施是防治高血压病.     

高血压合并脑出血80例临床分析

目的:探讨高血压脑出血患者的临床资料,总结高血压脑出血的诱发因素与初发症状、主要症状和体征,有效的预防脑出血的发生,提高治愈率,减少病死率。方法:回顾性分析80例高血压合并脑出血患者临床资料。结果:高血压合并脑出血高发年龄在48～58岁,具有高致残率、高致死率的特点。结论:只有加强高血压患者的健康教育,有效控制高血压,才能降低高血压病脑出血的发病率。     

高血压合并脑出血168例临床分析

目的掌握高血压合并脑出血病人的临床特点，有效的预防脑出血的发生，提高治愈率，减少病死率。方法将168例患高血压合并脑出血的病人进行临床分析。结果患病高发年龄在48-58岁，平均年龄57．7岁；死亡67例，占39．9％，病死率与年龄成正比。结论脑出血是高血压病最常见的并发症之一，并有高致残率和高死亡率，避免脑出血的发生主要措施是防治高血压病。     

高血压合并脑出血168例临床分析

目的掌握高血压合并脑出血病人的临床特点，有效的预防脑出血的发生，提高治愈率，减少病死率。方法将168例患高血压合并脑出血的病人进行临床分析。结果患病高发年龄在48-58岁，平均年龄57．7岁；死亡67例，占39．9％，病死率与年龄成正比。结论脑出血是高血压病最常见的并发症之一，并有高致残率和高死亡率，避免脑出血的发生主要措施是防治高血压病。     

180例脑出血临床分析

目的:通过对180例脑出血临床资料分析,探讨脑出血的相关因素。方法:对180例脑出血患者发病季节、年龄、病史、临床症状进行分析。结果:以60~69岁年龄组发病率高,冬春季发病率高,多数有高血压史,起病急,病死率与年龄、昏迷程度、有无脑干损害及上消化道出血等有关。结论:高血压是脑出血的主要危险因素,对高血压的治疗是降低发病率致残率和病死率的最有效措施。     

Surgical intervention for advanced valvular heart disease in 227 cases

Background Although the results of surgical treatment in cardiac valve disease continue to improve, the postoperative mortality rate and the rate of complications in patients with advanced valvular heart disease (AVHD) are still very high. We did this retrospective study to summarize the surgical experience of heart valve replacement for patients with AVHD and discuss effective ways to improve the surgical outcome.Methods From January 1994 to October 2003, surgical procedures of heart valve replacement were performed on 227 (136 men and 91 women) patients with AVHD in our Department of Cardiothoracic Surgery. The clinical data of all patients were collected and analysed. Patients’ age ranged from 10 years to 77 years. In preoperative cardiac function grading, 157 cases were NYHA III and 70 cases NYHA IV. Fifty-one patients had had cardiac operations. The ultrasonic cardiac graphs showed that 145 patients suffered from moderate or severe pulmonary hypertension and 73 had combined giant left ventricle. Mitral valve replacement was performed in 32 cases, aortic valve replacement in 90, tricuspid valve replacement in 1, combined mitral and aortic replacement in 103 and combined mitral and tricuspid replacement in 1. Nineteen patients also received surgical corrections for other minor abnormalities during the operations. A logistic model was established to evaluate the influence of perioperative factors on the mortality rate. Results The operative mortality rate was 13.2% (30/227). The main causes of death included multiple organ dysfunction syndrome (MODS), low cardiac output syndrome and ventricular fibrillation. From the results of the binary noncounterpart multivariate logistic regression, the following statistically significant factors were found to influence the operative mortality rate: redo operation, age ≥55 years, preoperative NYHA cardiac function grading, extracorporeal circulation time ≥120 minutes and postoperative usage of GIK (glucose, insulin and potassium) solution. All factors were risk ones except postoperative application of GIK. The Hosmer-Lemeshow goodness of fit coefficient of this model was 0.976. Conclusions The risk factors associated with postoperative mortality rate in the patients with AVHD were redo operation, age ≥55 years, preoperative NYHA cardiac function grading and extracorporeal circulation time ≥120 minutes. Postoperative usage of GIK acted as a kind of metabolic therapy and will improve the recovery for patients with AVHD. Active perioperative management and care will play a very important role in reducing the operative risk and improving the short term outcome of surgical treatment for the patients with AVHD.     

外科手术治疗原发性感染性心内膜炎疗效观察

目的探讨手术治疗原发性感染性心内膜炎的近远期效果。方法对2002年1月—2013年6月连续收治的符合Duke诊断标准的原发性感染性心内膜炎患者16例进行回顾性研究。主要终点事件为与感染性心内膜炎相关性死亡、二次手术、感染性心内膜炎复发。结果 16例患者中男12例,女4例,男女比为3:1,年龄25.0⁶0.6(46.7±13.9)岁,行二尖瓣置换术9例,主动脉瓣置换术4例,二尖瓣主动脉瓣联合置换术3例,30 d内病死率为18.8%(3/16)。随访12例,随访时间060.6(46.7±13.9)岁,行二尖瓣置换术9例,主动脉瓣置换术4例,二尖瓣主动脉瓣联合置换术3例,30 d内病死率为18.8%(3/16)。随访12例,随访时间0¹37(42.3±5.0)月,5年生存率为80.0%,远期死亡原因主要为心功能不全、感染性心内膜炎复发。结论感染性心内膜炎仍是高病死率疾病,心脏彩色超声可以提高其诊断率,早期手术有利于提高远期效果。     

A FIVE YEAR REPORT ON COMMUNITY CONTROL OF HYPERTENSION, STROKE AND CORONARY HEART DISEASE IN THE SHIJINGSHAN PEOPLE''S COMMUNE, BEIJING

Survey and community control of hyperten- sion, stroke and coronary heart disease have been carried out in the Shijingshan People's Com- mune, Beijing since 1975. The prevalence rate of hypertension (WHO criteria) in people over 15 years of age is 5.50'70. A simple regime of compound antihypertensive drugs brought satis- factory control of hypertension in 65.43'/o. The coronary heart disease prevalence rate in persons over 40 years of age is 3.93To. FonOw up in 114 cases shows a 5 year case fatality rate of 7.670 from cardiovascular complications. ECG follow up examination in 85 cases shows improvement or stationary changes in 83.5'70 0f the group. Review of the mortality statistics sho!ws a 13.03To reduction in the cardiovascular mortality rate and a 23.21To reduction in the stroke mor- tality rate.     

老年糖尿病住院患者死亡原因分析

OBJECTIVE: To understand the mortality rate and main death causes of aged diabetics in hospital. METHODS: The clinical record of 183 aged diabetic patients, who were hospitalized and died between January, 1995 and December, 2002 in our hospital, were reviewed in comparison with 293 non-diabetic aged patients hospitalized in the same period. RESULTS: The mortality rate of the aged diabetics was 13.11%, far beyond that of the non-diabetics. The main death causes of the diabetic patients were tumor (29.5%), cardiovascular diseases (CVD, 25.7%), pulmonary infections (14.2%), renal dysfunction (9.8%) and cerebral vascular diseases (5.5%). Tumor was the main cause of death in the diabetic patients 60 to 80 years of age, and in those 80-90 years old, CVD accounted for most of the deaths, whereas most patients over 90 years old died of pulmonary infections. When only one of the 3 risk factors, namely hypertension, dyslipidemia and smoking, was present, CVD accounted for 36.8% of all deaths; when all the 3 factors co-existed, CVD accounted for 50% of all deaths. CONCLUSIONS: The mortality rate of aged diabetics is higher than that of the non-diabetics. Tumor and CVD are the main causes of death, but the constituent ratio changes with age. The ratio of CVD in all death causes depends on the number of risk factors present, including hypertension, dyslipidemia and smoking.     

450例住院老年糖尿病患者死因分析

目的了解住院老年糖尿病患者死亡原因和特点。方法回顾和总结10所综合性医院450例老年糖尿病死亡病例,并将其与同期住院的152例非老年糖尿病死亡病例进行对照分析。结果前3位死因老年组为脑血管病、心血管病、肾衰竭,非老年组为酮症酸中毒、脑血管病、心血管病,组间死因构成差异有统计学意义(P=0.000);在老年组随着年龄的增长,合并肿瘤及感染的患者住院病死率增加;老年组与非老年组男性死因构成比差异无统计学意义(P=0.329)。老年组女性死因以脑、心血管病变及肾衰竭等慢性合并症为主,非老年组女性以酮症酸中毒等急性合并症为主差异有统计学意义(P=0.000);老年组高血压及血脂异常发生率高于非老年组,差异有统计学意义(P=0.000)。结论重视对绝经期后女性心血管病的防治,预防糖尿病慢性合并症,保护脏器功能,有效的控制高血糖、高血压、高血脂,积极防治感染,对减少老年糖尿病患者的死亡有重要意义。     

冠心病传统心血管病危(险因素的评价

目的 探讨传统的心血管病危险因素对冠心病(CHD)的价值.方法 对283例急性冠脉综合征(ACS)患者传统的心血管病危险因素(性别、年龄、高血压、糖尿病、血脂异常、吸烟)作回顾性分析.结果 男女CHD均以老年多见(χ2 =15.204,P＜0.001));＜60岁男女对比差异有统计学意义(χ2 =8.803,P＜0.01);283例CHD患者仅高血压与其它各危险因素对比差异有统计学意义(P＜0.001),等级相关及回归分析仅高血压与CHD有显著相关(r =0.993,t=15.654,P＜0.001).男性CHD以合并高血压及吸烟因素居多,女性CHD以高血压及糖尿病因素居多,男女CHD对比吸烟、糖尿病因素差异均有统计学意义(χ2 =23.916、χ2 =11.740,P＜0.001).高TG、低HDL-C与高TC、高LDL-C对比均差异有统计学意义(P＜0.05).除外性别、年龄随着危险因素数目的 增多CHD增加,合并2个危险因素组最多见,为35.3%,2个以上危险因素组冠心病并未随着危险因素增多而增加.结论 老年、高血压是CHD独立的危险因素;吸烟是男性CHD主要的危险因素,糖尿病是女性CHD主要的危险因素;男女CHD患病率与年龄有关,＜60岁时男性CHD发病率高于女性;血脂异常中高TG、低HDL-C为CHD主要的危险因素;CHD合并2个危险因素最多见.CHD的防治不仅要重视高危人群,也要加强低危人群的宣教和预防,综合干预和积极控制已明确的危险因素,可能对降低心血管疾病的发病率和死亡率具有积极作用.     

老老年高血压伴合并症临床治疗研究

目的为有效防治老老年伴合并症高血压,降低反复住院率和病死率。方法选择门诊或住院≥80岁伴合并症的高血压患者41例作为观察对象,其中高血压合并稳定型心绞痛31例,永久性房颤8例,慢性心功能不全16例2,型糖尿病者19例,慢性肾功能不全5例,闭塞性周围动脉粥样硬化症4例等。根据缓急、合并症的不同、危险因素、靶器官损害程度,实施个体化治疗方案。结果 6个月内有34例收缩压降至150 mmHg以下,有4例收缩压降至130 mmHg以下。40例病情好转,未出现新的合并症。结论对老老年伴合并症高血压患者,在全面评估病情的基础上,实施个体化治疗方案,将血压缓慢控制在150 mmHg以下,减缓了高血压进程,降低了反复住院率和病死率。     

242例围产儿死亡原因分析

对1979～1988年在我院分娩16079例中242例围产儿的死亡原因进行了分析。新生儿死亡116例,死胎99例,死产27例。尸检102例。围产儿死亡原因以宫内缺氧为主,其次为肺部疾患,先天性畸形等.孕周<37周,体重<2500克,臀位牵引的胎儿死亡率最高.围产儿死亡在产科并发症中主要为脐带因素,其次是胎盘因素,妊高症等.为进一步降低围产儿死亡率,今后必须加强产前保健工作.     

系统性红斑狼疮患者的心血管损害

本文报道系统性红斑狼疮(SLE)44例,其中心血管损害29例,发病率随病情进展增加,已成为SLE的常见死因。心血管损害中以心肌炎最为多见,可出现各种类型的心律失常并导致猝死。经激素治疗后,大多数心血管损害均有所缓解。