目的 了解急性腦血管病機(jī)械通氣患者院內(nèi)死亡的預(yù)后因素。方法 對(duì)大連醫(yī)科大學(xué)附屬第一醫(yī)院中心ICU 2005年1月~2007年12月間所有進(jìn)行機(jī)械通氣治療并且資料完整的94例急性腦血管病內(nèi)科患者的資料進(jìn)行回顧性分析，依據(jù)出院結(jié)果分為死亡組和生存組，對(duì)包括年齡、性別、病史、入院時(shí)的血?dú)夥治鲆约凹毙陨韺W(xué)和慢性健康狀況評(píng)分系統(tǒng)Ⅱ（APACHEⅡ）評(píng)分等各項(xiàng)指標(biāo)進(jìn)行單因素及多因素Logistic回歸分析。結(jié)果 50例（53.2%）死亡，44例（46.8%）生存出院。單因素分析發(fā)現(xiàn)兩組間APACHEⅡ評(píng)分、血糖、總住院時(shí)間、ICU住院時(shí)間、機(jī)械通氣時(shí)間、氣管切開、肺內(nèi)感染、病變部位及性質(zhì)有顯著差異（P均 lt;0.05）。多因素Logistic回歸分析表明血糖、肺內(nèi)感染、幕下病變、機(jī)械通氣時(shí)間是增加院內(nèi)死亡風(fēng)險(xiǎn)的獨(dú)立預(yù)后危險(xiǎn)因素（P均 lt;0.05），而ICU住院時(shí)間為保護(hù)性因素（P lt;0.05）。結(jié)論 需機(jī)械通氣的急性腦血管病患者病死率高，治療過程中應(yīng)積極控制血糖及肺內(nèi)感染等預(yù)后危險(xiǎn)因素，并對(duì)患者的預(yù)后做出正確評(píng)估。
引用本文： 張久之,萬(wàn)獻(xiàn)堯,吳向東. 急性腦血管病機(jī)械通氣患者院內(nèi)死亡的預(yù)后因素分析. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2008, 08(4): 281-285. doi: 復(fù)制
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| 4. | Ovary C，Suzuki K，Nagy Z．Regional differences in incidence rates，outcome predictors and survival of stroke.Neuroepidemiology，2004，23：240-246. |
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| 7. | Kazumi K，Yasuyuki I，Takeshi I，et al.Hyperglycemia independently increases the risk of early in acute spontaneous intracerebral hemorrhage.Journal of the Neurological Sciences，2007，255：90-94. |
| 8. | McCowen KC，Malhottra A，Bistrian BR.Stress-induced hyperglycemia.Crit Care，2001，17：107-124. |
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| 10. | Leigh R，Zaidat OO，Suri MF，et al.Predictors of hyperacute clinical worsening in ischemic stroke patients receiving thrombolytic therapy.Stroke，2004，35：1903-1907. |
| 11. | Song EC，Chu K，Jeong SW，et al.Hyperglycemia exacerbates brain edema and perihematomal cell death after intracerebral hemorrhage.Stroke，2003，34：2215-2220. |
| 12. | Garg R，Chaudhuri A，Munschauer F，et al.Hyperglycemia，insulin，and acute ischemic stroke：a mechanistic justification for a trial of insulin infusion therapy.Stroke，2006，37：267-273. |
| 13. | Van den Berghe G，Schoonheydt K，Becx P，et al.Insulin therapy protects the central and peripheral nervous system of intensive care patients.Neurology，2005，64：1348-1353. |
| 14. | Federico B，Allison S，F(xiàn)ederico G，et al.The Effect of Intensive Insulin Therapy on Infection Rate，Vasospasm，Neurologic Outcome，and Mortality in Neurointensive Care Unit After Intracranial Aneurysm Clipping in Patients With Acute Subarachnoid Hemorrhage.Neurosurg Anesthesiol，2007，19：156-160. |
| 15. | 黃偉，李曉楓，萬(wàn)獻(xiàn)堯，等.長(zhǎng)期機(jī)械通氣患者的預(yù)后因素分析.中國(guó)呼吸與危重監(jiān)護(hù)雜志，2004，3：167-169. |
| 16. | 黃偉，秦詠梅，萬(wàn)獻(xiàn)堯，等.老年長(zhǎng)期機(jī)械通氣患者的預(yù)后影響因素.大連醫(yī)科大學(xué)學(xué)報(bào)，2004，26：197-199. |
| 17. | Cho DY，Wang YC.Comparison of the APACHEⅢ，APACHEⅡ and Glasgow Come Scale in the acute head injury for prediction of mortality and functional outcome.Intensive Care Med，1997，23：77-84. |
| 18. | 孟新科.APACHE評(píng)分系統(tǒng)的研究現(xiàn)狀及展望.中國(guó)急救醫(yī)學(xué)雜志，2001，21：430-431. |
| 19. | Michael Z，Rolando B.Tracheostomy in the critically ill patient：who，when，and how?.Clinical Pulmonary Medicine.2006，13：111-120. |
- 1. 2 Mayer SA，Copeland D，Bernardini GL，et a1.Cost and outcome of mechanical ventilation for life-threatening stroke.Stroke，2000，31：2346-2353. 3 Hamidon BB，Nabil I，Raymond AA.Risk factors and outcome of dysphagia after an acute ischaemic stroke.Med J Malaysia，2006，61：553-557.
- 2.
- 3.
- 4. Ovary C，Suzuki K，Nagy Z．Regional differences in incidence rates，outcome predictors and survival of stroke.Neuroepidemiology，2004，23：240-246.
- 5. Karapanaylotides T，Piechowski-Jozwiak B，vail MeUeg G，et al．Stroke patterns，etiology，and prognosis in patients with diabetes mellitus．Neurology，2004，62：1558-1562.
- 6. Heuschmann PU，Kolominsky-Rabas PL，Misselwitz B，et al.Predictors of in-hospital mortality and attributable risks of death after ischemic stroke：the German Stroke Registers Study Group.Arch Intern Med，2004，164：1761-1768.
- 7. Kazumi K，Yasuyuki I，Takeshi I，et al.Hyperglycemia independently increases the risk of early in acute spontaneous intracerebral hemorrhage.Journal of the Neurological Sciences，2007，255：90-94.
- 8. McCowen KC，Malhottra A，Bistrian BR.Stress-induced hyperglycemia.Crit Care，2001，17：107-124.
- 9. Christensen H，Boysen G．Blood glucose increases early after stroke onset：a study on serial measurements of blood glucose acute stroke．Eur J Neurol，2002，9：297-301.
- 10. Leigh R，Zaidat OO，Suri MF，et al.Predictors of hyperacute clinical worsening in ischemic stroke patients receiving thrombolytic therapy.Stroke，2004，35：1903-1907.
- 11. Song EC，Chu K，Jeong SW，et al.Hyperglycemia exacerbates brain edema and perihematomal cell death after intracerebral hemorrhage.Stroke，2003，34：2215-2220.
- 12. Garg R，Chaudhuri A，Munschauer F，et al.Hyperglycemia，insulin，and acute ischemic stroke：a mechanistic justification for a trial of insulin infusion therapy.Stroke，2006，37：267-273.
- 13. Van den Berghe G，Schoonheydt K，Becx P，et al.Insulin therapy protects the central and peripheral nervous system of intensive care patients.Neurology，2005，64：1348-1353.
- 14. Federico B，Allison S，F(xiàn)ederico G，et al.The Effect of Intensive Insulin Therapy on Infection Rate，Vasospasm，Neurologic Outcome，and Mortality in Neurointensive Care Unit After Intracranial Aneurysm Clipping in Patients With Acute Subarachnoid Hemorrhage.Neurosurg Anesthesiol，2007，19：156-160.
- 15. 黃偉，李曉楓，萬(wàn)獻(xiàn)堯，等.長(zhǎng)期機(jī)械通氣患者的預(yù)后因素分析.中國(guó)呼吸與危重監(jiān)護(hù)雜志，2004，3：167-169.
- 16. 黃偉，秦詠梅，萬(wàn)獻(xiàn)堯，等.老年長(zhǎng)期機(jī)械通氣患者的預(yù)后影響因素.大連醫(yī)科大學(xué)學(xué)報(bào)，2004，26：197-199.
- 17. Cho DY，Wang YC.Comparison of the APACHEⅢ，APACHEⅡ and Glasgow Come Scale in the acute head injury for prediction of mortality and functional outcome.Intensive Care Med，1997，23：77-84.
- 18. 孟新科.APACHE評(píng)分系統(tǒng)的研究現(xiàn)狀及展望.中國(guó)急救醫(yī)學(xué)雜志，2001，21：430-431.
- 19. Michael Z，Rolando B.Tracheostomy in the critically ill patient：who，when，and how?.Clinical Pulmonary Medicine.2006，13：111-120.