[1]谯　飞　陈　兵　赵　伟　李承科　唐　辉　任海波　冯　浩　何家全.血液透析病人并发脑出血预后的影响因素[J].中国临床神经外科杂志,2019,(05):279-280285.[doi:10.13798/j.issn.1009-153X.2019.05.007]
　QIAO Fei,CHEN Bing,ZHAO Wei,et al.Factors related to the prognoses in maintenance hemodialysis patients with intracranial hemorrhage[J].,2019,(05):279-280285.[doi:10.13798/j.issn.1009-153X.2019.05.007]
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血液透析病人并发脑出血预后的影响因素()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年05期
页码:
279-280285
栏目:
论著
出版日期:
2019-05-27

文章信息/Info

Title:
Factors related to the prognoses in maintenance hemodialysis patients with intracranial hemorrhage
文章编号:
1009-153X（2019）05-0279-02
作者:
谯　飞　陈　兵　赵　伟　李承科　唐　辉　任海波　冯　浩　何家全
637000 四川，南充市中心医院神经外科（谯　飞、陈　兵、赵　伟、李承科、唐　辉、任海波、冯　浩、何家全）
Author(s):
QIAO Fei;  CHEN Bing;  ZHAO Wei;  LI Cheng-ke;  TANG Hui;  REN Hai-bo;  FENG Hao;  HE Jia-quan
Department of Neurosurgery, Nanchong Municipal Central Hospital, Nanchong 637000, China
关键词:
脑出血; 血液透析; 预后; 影响因素
Keywords:
Intracranial hemorrhage;  Hemodialysis;  Prognoses;  Risk factors
分类号:
R 743.34
DOI:
10.13798/j.issn.1009-153X.2019.05.007
文献标志码:
A
摘要:
目的 探讨血液透析病人并发脑出血预后的影响因素。方法 回顾性分析2013年7月至2018年7月收治的48例血液透析并发脑出血的临床资料。根据发病30 d改良Rankin量表（mRS）评分评估预后，0~2分为预后良好，3~6分为预后不良。采用多因素Logistic回归分析检验预后影响因素。结果 48例中，预后良好22例，预后不良26例。多因素Logistic回归分析显示年龄≥60岁、脑出血≥30 mL、入院时GCS评分≤12分、平均动脉压≥130 mmHg、白蛋白水平<30 g/dl是预后不良的独立危险因素（P<0.05）。结论 血液透析病人并发脑出血的预后较差，需要全面评估脑出血风险，采用及早、有针对性的干预，积极控制脑出血量，稳定血压和白蛋白水平，以期减少并发症和改善预后。
Abstract:
ObjectiveTodiscussthefactorsrelatedtotheprognosesinmaintenancehemodialysis(MHD)patientswithintracranialhemorrhage(ICH).MethodsOf48MHDpatientswithICHtreatedinourhospitalfromJuly,2013toJuly,2018,22hadgoodprognosesand26hadpoorprognoses.ThefactorsrelatedtotheirprognoseswereanalyzedbymultivariateLogisticregressionanalysis.ResultsThemultivariateLogisticregressionshowedthattheindependentriskfactorrelatedtothepoorprognosesincludedthepatients’age≥60years,hemorrhagevolume≥30ml,GCSscore≤12onadmission,themeanarterialpressure≥130mmHgandplasmaalbuminlevel<30g/dl(P<0.05).ConclusionsTheprognosesarepoorintheMHDpatientswithCIH.Activelyreducinghemorrhagevolume,andstabilizingthemeanarterialpressureandplasmaalbuminlevelareveryhelptotheimprovementoftheprognoses.

参考文献/References:


[1] Power A, Chart K, Singh SK, et al. Appraising stroke risk in maintenance hemodialysis patients: a large single-center cohort study [J]. Am J Kidney Dis, 2012, 59(2): 249-257.
[2] Huang BR, Liao CC, Huang WH, et al. Prognostic factors of spontaneous intracerebral haemorrhage in haemodialysis patients and predictors of 30-day mortality [J]. Intern Med J, 2008, 38(7): 568-574.
[3] Ikeda K, Tsuchimochi H, Takeno Y, et al. Clinical analysis of the patients with hemodialysis associated with intracere-bral hematoma [J]. No Shinkei Geka, 2004, 32(11): 1133-1137.
[4] 蒋志玲. 维持性血液透析并发脑出血的危险因素分析[J]. 中国实用神经疾病杂志，2017，20（15）：109-111.
[5] Wakasugi M, Matsuo M, Kazama JJ, et al. Higher mortality due to intracerebral hemorrhage in dialysis patients: a comparison with the general population in Japan [J]. Ther Apher Dia, 2015, 19(1): 45-49.
[6] Hsieh CY, Chen CH, Wu AB, et al. Comparative outcomes between hemo- and peritoneal dialysis patients with acute intracerebral hemorrhage [J]. Am J Nephrol, 2010, 32(1): 31-37.
[7] Yamashita S, Kimura K, Iguchi Y, et al. Prior oral anti-thrombotic therapy is associated with early death in patients with supratentorial intracerebral hemorrhage [J]. Intern Med2011, 50(5): 413-419.
[8] Naganuma T, Takemoto Y, Shoji T, et al. Cerebral micro-bleeds predict intracerebral hemorrhage in hemodialysis patients [J]. Stroke, 2015, 46(8): 2107-2112.
[9] Kumar A, Cage A, Dhar R. Dialysis-induced worsening of cerebral edema in intracranial hemorrhage: a case series and clinical perspective [J]. Neurocrit Care, 2015, 22(2): 283-287.
[10] 王文涛，陈燕梅. 长期血液透析病人并发颅内出血的治疗策略[J]. 黑龙江医学，2014，38（9）：1005-1006.

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备注/Memo

备注/Memo:

通讯作者：何家全，E-mail：41452488@qq.com
更新日期/Last Update: 2019-05-27