基底节区高血压脑出血患者术后生活质量与临床指标的影响因素分析
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摘要
目的了解基底节区高血压脑出血术后患者的生活质量,探讨患者术后生活质量的影响因素。方法回顾性调查256例基底节区高血压脑出血患者的一般人口学资料、手术期间各项临床客观指标,采用SF-36量表对患者的生活质量进行测评,分析生活质量总分及各维度得分,采用多重线性回归模型对其影响因素进行单因素及多因素分析。结果术后患者生活质量标准化总分为(65. 30±6. 17)分,生理健康领域和心理健康领域得分分别为(66. 05±5. 58)分和(64. 54±5. 61)分。患者术后SF-36量表总得分有影响的因素为出血破入脑室;对生理功能(PF)有影响的因素为出血破入脑室和脑中线位移;对生理职能(RP)有影响的因素为Barthel指数;对躯体疼痛(BP)有影响的因素为Barthel指数;对总体健康(GH)有影响的因素为出血破入脑室、GCS评分和Barthel指数;对活力(VT)有影响的因素为出血破入脑室;对社会功能(SF)有影响的因素为出血破入脑室;对情感职能(RE)有影响的因素为出血破入脑室;对精神健康(MH)有影响的因素为出血破入脑室。结论基底节区高血压脑出血术后患者生活质量不高,其主要影响因素有出血破入脑室、脑中线位移、GCS评分和Barthel指数等。
Objective To investigate the postoperative quality of life in patients with hypertensive basal ganglia hemorrhage,analyze the correlation between quality of life and clinical indicators and explore the influencing factors of postoperative quality of life.Methods The general demographic data and the clinical objective indexes during the operation in 256 patients with hypertensive basal ganglia hemorrhage were retrospectively analyzed.Quality of life of the patients was evaluated by the SF-36 health measurement scale.The relationship among the total and dimensional scores of the life quality and the main objective clinical indexes was analyzed.Univariate and multivariate linear regression models were used to analyze the influencing factors.Results The total score of the quality of life of the patients was 65. 30 ± 6. 17,and the scores in the field of physical health and mental health were 66. 05 ± 5. 58 and 64. 54 ±5. 61,respectively.The factors influencing the total score of the SF-36 scale were the hemorrhage broking into the ventricle.The factors affecting the score of the physiological function( PF) were bleeding into the ventricles and midbrain line displacement.The factors affecting the score of role-physiology( RP) were the Barthel index.The factor affecting the score of body pain( BP) was the Barthel index.The factors affecting the general health( GH) were bleeding into the ventricle,the GCS score and the Barthel index.The factor affecting the score of vitality( VT) was bleeding.The factor that affects the score of social function( SF) was bleeding into the ventricle,and the factor that affects the score of emotional role( RE) was bleeding into the ventricle,and the factor that affects the score of mental health( MH) was bleeding into the ventricle.Conclusion The postoperative quality of life of the patients with hypertensive basal ganglia hemorrhage is not high.It is mainly related with the bleeding into the ventricle,the midbrain line displacement,the GCS score and the Barthel index.
Objective To investigate the postoperative quality of life in patients with hypertensive basal ganglia hemorrhage,analyze the correlation between quality of life and clinical indicators and explore the influencing factors of postoperative quality of life.Methods The general demographic data and the clinical objective indexes during the operation in 256 patients with hypertensive basal ganglia hemorrhage were retrospectively analyzed.Quality of life of the patients was evaluated by the SF-36 health measurement scale.The relationship among the total and dimensional scores of the life quality and the main objective clinical indexes was analyzed.Univariate and multivariate linear regression models were used to analyze the influencing factors.Results The total score of the quality of life of the patients was 65. 30 ± 6. 17,and the scores in the field of physical health and mental health were 66. 05 ± 5. 58 and 64. 54 ±5. 61,respectively.The factors influencing the total score of the SF-36 scale were the hemorrhage broking into the ventricle.The factors affecting the score of the physiological function( PF) were bleeding into the ventricles and midbrain line displacement.The factors affecting the score of role-physiology( RP) were the Barthel index.The factor affecting the score of body pain( BP) was the Barthel index.The factors affecting the general health( GH) were bleeding into the ventricle,the GCS score and the Barthel index.The factor affecting the score of vitality( VT) was bleeding.The factor that affects the score of social function( SF) was bleeding into the ventricle,and the factor that affects the score of emotional role( RE) was bleeding into the ventricle,and the factor that affects the score of mental health( MH) was bleeding into the ventricle.Conclusion The postoperative quality of life of the patients with hypertensive basal ganglia hemorrhage is not high.It is mainly related with the bleeding into the ventricle,the midbrain line displacement,the GCS score and the Barthel index.
引文
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[11]游潮,刘鸣,李浩.高血压脑出血诊治中的若干问题[J].中国脑血管病杂志,2011,8(4):169-171.
[12]张乐,赵延芳,关素珍.乌鲁木齐市某区老年人健康相关生命质量及影响因素[J].中国老年学杂志,2017,37(1):200-202.
[13]杨清武.中国脑出血研究进展回顾与展望[J].中华医学信息导报,2016,31(15):21.
[14]王文娟,王春雪,杨中华,等.中国脑出血医疗现状及死亡相关因素分析[J].中国卒中杂志,2013,8(9):703-711.
[15]王予.社区居民生命质量影响因素的多元线性回归分析[J].中国卫生统计,2017,34(1):94-96.
[16]袁鸿江,张俊,孙敏.脑卒中后6~9月与两年的生存质量比较[J].老年医学与保健,2002,8(1):17-20.
[17]Liu Z,Chen Q,Tian D,et al.Clinical significance of dynamic monitoring by transcranial doppler ultrasound and intracranial pressure monitor after surgery of hypertensive intracerebral hemorrhage[J]. Int J Clin Exp Med,2015,8(7):11456-11462.
[2]Liu H,Zen Y,Li J,et al. Optimal treatment determination on the basis of haematoma volume and intra-cerebral haemorrhage score in patients with hypertensive putaminal haemorrhages:a retrospective analysis of 310 patients[J].BMC Neurol,2014,14:141.
[3]官念,吴碧华,刘黎明,等.脑出血病因及相关机制的研究进展[J].中华老年心脑血管病杂志,2016,18(6):670-672.
[4]滕楚北,屈洪涛.三种不同手术方法在高血压性脑出血患者中的应用与比较[J].中国现代医药杂志,2017,19(11):48-51.
[5]屠传建,顾志伟,柳建生,等.高血压脑出血预后模型的建立及验证[J].中华急诊医学杂志,2017,26(10):1183-1186.
[6]张树新,张洪振,张维兵.神经内镜下治疗基底节区高血压性脑出血[J].中华神经外科杂志,2017,33(1):28-29.
[7]刘湘,刘劲睿.高血压脑出血外科治疗进展[J].湖北民族学院学报(医学版),2017,34(4):69-71.
[8]Cusack TJ,Carhuapoma JR,Ziai WC. Update on the Treatment of Spontaneous Intraparenchymal Hemorrhage:Medical and Interventional Management[J]. Curr Treat Options Neurol,2018,20(1):1.
[9]张长福,谭占国,袁波,等.基底节区高血压性脑出血的临床治疗经验[J].中华神经外科杂志,2017,33(12):1266-1267.
[10]郭强,张爱莲,宋志斌,等.基底节区高血压脑出血术后患者生命质量及影响因素分析[J].中华物理医学与康复杂志,2016,38(7):514-523.
[11]游潮,刘鸣,李浩.高血压脑出血诊治中的若干问题[J].中国脑血管病杂志,2011,8(4):169-171.
[12]张乐,赵延芳,关素珍.乌鲁木齐市某区老年人健康相关生命质量及影响因素[J].中国老年学杂志,2017,37(1):200-202.
[13]杨清武.中国脑出血研究进展回顾与展望[J].中华医学信息导报,2016,31(15):21.
[14]王文娟,王春雪,杨中华,等.中国脑出血医疗现状及死亡相关因素分析[J].中国卒中杂志,2013,8(9):703-711.
[15]王予.社区居民生命质量影响因素的多元线性回归分析[J].中国卫生统计,2017,34(1):94-96.
[16]袁鸿江,张俊,孙敏.脑卒中后6~9月与两年的生存质量比较[J].老年医学与保健,2002,8(1):17-20.
[17]Liu Z,Chen Q,Tian D,et al.Clinical significance of dynamic monitoring by transcranial doppler ultrasound and intracranial pressure monitor after surgery of hypertensive intracerebral hemorrhage[J]. Int J Clin Exp Med,2015,8(7):11456-11462.