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目的评价突发性脑溢血患者急诊内科急救效果,分析急救要点。方法回顾性分析急诊内科既往收治的74例突发性脑溢血患者病历资料,对比预后良好与不佳者临床资料。结果 74例患者中,8例出现并发症,其中4例脑水肿,3例脑水肿合并消化道出血,1例出现消化道出血;院内5例患者死亡;存活患者平均住院时间11~35 d,脑神经功能缺损评分15~33分,平均评分(28±8)分;发病至1个月后,格拉斯哥预后评分(GOS评分)死亡5例、1例植物生存(仍住院)、34例重度残疾、20例轻度残疾、14例恢复良好;预后良好者年龄、发病至送院时间、出血量低于预后不佳者,差异具有统计学意义(P<0.05)。结论突发脑溢血急诊内科患者整体预后相对更好,这与收治患者病情相对较轻有关,出血量、发病至送院时间、有无并发症、年龄直接影响患者预后。
Objective To evaluate the emergency medical emergency response in patients with sudden cerebral hemorrhage and analyze the first aid points. Methods The clinical data of 74 patients with sudden cerebral hemorrhage admitted in emergency department were retrospectively analyzed. The clinical data of patients with good prognosis and poor prognosis were compared. Results Among the 74 patients, 8 cases had complications including 4 cases of cerebral edema, 3 cases of cerebral edema with gastrointestinal bleeding, 1 case of gastrointestinal bleeding, 5 cases of death in hospital and 11 ~ 35 days of survival in survivors, The neurological deficit scores ranged from 15 to 33 with a mean score of 28 ± 8. Five months after the onset of the Glasgow Prognosis (GOS) score, 1 patient survived (still hospitalized) and 34 with severe disability , 20 cases with mild disability and 14 cases recovered well. The patients with good prognosis had significant differences in age, onset to hospital admission, and bleeding less than those with poor prognosis (P <0.05). Conclusions The overall prognosis of emergency patients with sudden cerebral hemorrhage is relatively better, which is related to the relatively mild condition of the patients admitted to the hospital. The amount of bleeding, the time from hospitalization to hospital admission, and the presence of complications and age directly affect the prognosis of the patients.