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目的:分析蛛网膜下腔出血再出血的危险因素及干预对策,以期为临床提供借鉴。方法:回顾自2009年6月至2013年12月入我院诊断为蛛网膜下腔出血的患者为研究对象,对患者的一般情况,如性别、年龄、高血压、糖尿病、再出血季节、感染、激动情绪、吸烟、酗酒、便秘、咳嗽、运动过早或加剧等数据进行生存分析,评价蛛网膜下腔出血再出血的危险因素。结果:在我们观察的160患者中,年龄16-86岁,平均年龄46.5±16.5岁,男性共132例,女性28例,共有42例发生再出血。通过对患者众多情况的单因素logistic分析,感染、激动情绪、酗酒、便秘、年龄、高血压、咳嗽、冬季,P<0.05,将之纳入多因素分析。通过多因素非条件Logistic回归分析,激动情绪(P=0.000)、酗酒(P=0.002)、便秘(P=0.003)、年龄(P=0.000)、高血压(P=0.000)、咳嗽(P=0.000)为蛛网膜下腔出血再出血的危险因素。结论:激动情绪、酗酒、便秘、年龄、高血压、咳嗽为蛛网膜下腔出血再出血的危险因素。应注意情绪、饮酒、血压的控制、保持大便通畅,必要时应用镇咳药控制咳嗽。
OBJECTIVE: To analyze the risk factors of subarachnoid hemorrhage and re-bleeding and intervention strategies to provide reference for clinical practice. Methods: The patients diagnosed as subarachnoid hemorrhage in our hospital from June 2009 to December 2013 were retrospectively analyzed. The general conditions of the patients such as gender, age, hypertension, diabetes, rebleeding season, infection , Exasperation, smoking, alcohol abuse, constipation, cough, premature exercise or exacerbations, and other data for survival analysis, evaluation of subarachnoid hemorrhage and bleeding risk factors. Results: Of the 160 patients we observed, aged 16-86 years with a mean age of 46.5 ± 16.5 years, there were 132 males and 28 females. A total of 42 patients had rebleeding. Multivariate analysis was included in the multivariate analysis by univariate logistic analysis of many patient conditions, infection, agitation, alcoholism, constipation, age, hypertension, cough, winter, p <0.05. Multivariate non-conditional Logistic regression analysis showed that emotional stress (P = 0.000), alcoholism (P = 0.002), constipation (P = 0.003), age (P = 0.000), hypertension (P = 0.000), cough (P = 0.000) for the subarachnoid hemorrhage bleeding risk factors. Conclusion: Excitement, alcoholism, constipation, age, hypertension and cough are the risk factors for rebleeding of subarachnoid hemorrhage. Should pay attention to emotions, alcohol, blood pressure control, keep the stool smooth, if necessary, the use of antitussive cough control.