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目的:分析急性脑卒中并发上消化道出血的相关危险因素及其对预后的影响。方法:将2011年1月—2013年12月收治的急性脑卒中患者563例分别按缺血性脑卒中与出血性脑卒中,有无意识障碍,有无脑疝各分为两组,分别比较其上消化道出血发生率;按有无并发上消化道出血分为两组,比较两组间GCS评分、肺炎发生率、MODS发生率以及病死率。结果:出血性脑卒中上消化道出血发生率高于缺血性脑卒中;意识障碍组上消化道出血发生率高于非意识障碍组;并发脑疝组上消化道出血发生率高于非并发脑疝组;脑卒中伴上消化道出血组GCS评分低于无伴上消化道出血组;脑卒中伴上消化道出血组肺炎发生率、MODS发生率以及病死率均明显高于无伴上消化道出血组(P<0.01)。结论:并发上消化道出血是急性脑卒中病情危重的一个独立因素,且其预后差。
Objective: To analyze the risk factors associated with upper gastrointestinal bleeding in acute stroke and its effect on prognosis. Methods: From January 2011 to December 2013, 563 acute stroke patients were divided into two groups according to ischemic stroke and hemorrhagic stroke, with or without disturbance of consciousness, with or without hernia, The incidence of upper gastrointestinal bleeding was divided into two groups according to the presence or absence of upper gastrointestinal bleeding. The GCS score, the incidence of pneumonia, the incidence of MODS and the mortality were compared between the two groups. Results: The incidence of upper gastrointestinal bleeding in hemorrhagic stroke was higher than that in ischemic stroke. The incidence of upper gastrointestinal bleeding in unconscious group was higher than that in non-unconscious group. The incidence of upper gastrointestinal bleeding in patients with cerebral hernia was higher than that in non-concomitant Cerebral hernia group; GCS score of stroke with upper gastrointestinal bleeding group was lower than that without accompanying upper gastrointestinal bleeding group; incidence of pneumonia, incidence of MODS and mortality in patients with stroke and upper gastrointestinal bleeding were significantly higher than those without accompanying upper digestion Hemorrhage group (P <0.01). Conclusions: Concurrent upper gastrointestinal bleeding is an independent risk factor for acute stroke and its prognosis is poor.