外科手术治疗脑卒中瘫痪病人的预后相关因素研究

目的探讨外科手术治疗脑卒中瘫痪病人的预后相关因素。方法回顾性分析我院经血肿清除手术治疗的90例脑卒中瘫痪患者的临床资料,随访8个月,根据Barthel指数评分分析患者预后状况。根据Barthel指数评分分为实验组和对照组,实验组35例,Barthel指数50分,为预后良好组;对照组65例,Barthel指数≤50分,为预后不佳组。采用Logistic逐步回归分析,分析影响脑卒中瘫痪经手术治疗患者预后的因素。结果 Logistic回归分析显示,影响脑卒中瘫痪经手术治疗患者预后的单因素包括高血压、患病类型、GCS评分、NIHSS分值、WBC水平、血钾浓度等;多因素分析进一步表明,高血压对患者预后的影响最大(OR=3.651),其次是糖尿病(OR=3.371)、血钾浓度(OR=2.946)等。结论影响脑卒中瘫痪经手术治疗患者预后的因素有多种,尤其是高血压、糖尿病、血钾浓度等,应采取相应措施缓解患者的临床不良症状,对脑卒中瘫痪患者的预后状况、降低致残率、致死率具有重要临床意义。

Related factors analysis of operative prognosis in stroke patients complicated with paralysis

Objective To investigate the related factors of operative prognosis in stroke patients complicated with paralys‐is .Methods Clinical data of 100 stroke cases with paralysis treated by evacuation of hematoma were retrospectively analyzed for 8‐month follow‐up .According to Barthel index scores ,35 patients with scores>50 points that showed benign prognosis were classified into study group and 65 cases with scores≤50 points that indicated bad prognosis were regarded as control group .We analyzed the potential factors influencing prognosis by using Logistic regression analysis .Results Logistic regression analysis showed that the potential univariate factors included hypertension ,type of illness ,GCS scores ,NIHSS scores ,WBC level ,serum potassium concentration ;Multivariate analysis further suggested that hypertension was the largest factor affecting the progno‐sis (OR=3 .651) ,followed by diabetes (OR=3 .371) ,serum potassium concentration (OR=2 .946) and so on .Conclusion There are many factors mainly including hypertension ,diabetes ,serum potassium concentration and other factors that affect the prognosis of stroke .It may be clinical significant that we should take appropriate measures to mitigate clinical symptoms of the paralysis and reduce mortality .