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目的:分析自发性脑出血(ICH)术后并发多器官功能障碍综合征(MODS)的危险因素,以及ICH术后的中医证型和所用方药的分布情况。方法:收集54例ICH术后患者的病历资料,根据术后有无发生MODS分为MODS组与非MODS组。入院后,对2组患者进行格拉斯哥昏迷评分法(GCS)评分,计算2组发病至手术开始时间以及术后机械通气时间,并对2组患者进行中医辨证分组及方药分布统计。结果:2组GCS评分、发病至手术开始时间及术后机械通气时间>48 h的患者所占比例比较,差异均有统计学意义(P<0.05,P<0.01)。GCS评分、发病至手术开始时间及术后机械通气时间与MODS的发生呈正相关(P<0.05,P<0.01)。MODS组方药使用集中于羚角钩藤汤和涤痰汤,非MODS组方药则集中于羚角钩藤汤、涤痰汤和天麻钩藤饮。结论:GCS评分、发病至手术开始时间及术后机械通气时间均会影响MODS的发生,可作为ICH术后继发MODS的预测指标。ICH术后患者发病多与“风、火、痰、瘀”有关,可从“熄风、清热、化痰、活血”进行干预治疗。
Objective: To analyze the risk factors of multiple organ dysfunction syndrome (MODS) after spontaneous intracerebral hemorrhage (ICH) and the distribution of TCM prescriptions and prescriptions used after ICH. Methods: The clinical data of 54 ICH patients were collected, and divided into MODS group and non-MODS group according to the presence or absence of postoperative MODS. After admission, two groups of patients were scored by Glasgow Coma Scale (GCS), the incidence of the two groups was calculated to the time of surgery and the time of mechanical ventilation. The two groups of patients were divided into TCM syndrome differentiation group and prescription distribution statistics. Results: There were significant differences in the proportions of GCS score, onset time to operation and postoperative mechanical ventilation> 48 h (P <0.05, P <0.01). The GCS score, the onset of the operation and the time of mechanical ventilation were positively correlated with the occurrence of MODS (P <0.05, P <0.01). MODS group prescriptions focused on Ling horn hook Undeytang Decoction and Ditan Decoction, non-MODS prescription drugs are concentrated in Ling angle Undeytory Tang, Ditan soup and Tianma Goutengyin. Conclusion: The incidence of MODS may be affected by the GCS score, the onset of the operation and the time of mechanical ventilation. It can be used as a predictor of secondary MODS after ICH. The incidence of ICH patients after surgery and “wind, fire, phlegm, blood stasis ” related, from “Xifeng, heat, phlegm, blood ” intervention treatment.