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学科主题: 麻醉学
题名:
普通外科和骨科术后脑卒中预后因素的巢式病例-对照研究
其他题名: Prognostic factors of postoperative stroke in general and orthopedic surgeries :a nested case-control study
作者: 李刚; 曲亦伸; 李楠; 张利萍; 樊东升; 刘忠军; 修典荣; 朱曦; 赵一鸣
关键词: 术后脑卒中 ; 预后因素 ; 巢式病例-对照研究 ; Postoperative stroke ; Prognostic factor ; Nested case-control study
刊名: 中华医学杂志
发表日期: 2015
DOI: 10.3760/cma.j.issn.0376-2491.2015.14.012
卷: 95, 期:14, 页:1088-1092
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 采用巢式病例-对照研究分析普通外科和骨科手术患者的术后脑卒中相关预后因素.方法 检索我院2009年1月至2011年12月行普通外科、骨科手术的病历,收集出院诊断有脑卒中记载的596例患者,对其中术后新发生的脑卒中患者29例(病例组),采用巢式病例-对照研究方法,按1∶6匹配同期同类未发生脑卒中手术病例174例作为对照组,探讨年龄、美国麻醉医师协会(ASA)分级、高血压、糖尿病、房颤、脑卒中或短暂性脑缺血发作(TIA)史、术中非房颤性心律失常等因素对术后脑卒中的影响.结果 单因素分析显示年龄、高血压、糖尿病、脑卒中或TIA史、术中发生非房颤心律失常是术后脑卒中发生的预后因素.多因素Logistic回归分析显示术前脑卒中或TIA史、房颤及年龄是术后脑卒中发生的独立预后因素,其中脑卒中或TIA史对术后脑卒中影响最显著(OR=13.01),其次为房颤(OR=7.77)和年龄(OR=6.40).结论 脑卒中或TIA史、房颤及年龄是术后脑卒中的独立预后因素.高血压、糖尿病、术中非房颤性心律失常是术后脑卒中预后因素. Objective To evaluate the prognostic factors of postoperative stroke in general and orthopedic surgeries using a nested case-control design.Methods The retrieval of information was performed from the medical records database in the Peking University Third Hospital.A total of 596 records with stroke diagnosis from January 2009 to December 2011 were recruited as the study cases,among which 29 cases were diagnosed with stroke occurred postoperatively.174 cases with similar surgical types,date of operation and anesthesia technique were explored as control group according to the principle of the nested case-control design.The data were analyzed using Logistic regression model.Results Univariate analysis showed that age,hypertension,diabetes,stroke or TIA history,non-atrial arrhythmias during surgery were prognostic factors for postoperative stroke.Logistic regression analysis showed that patients with stroke or TIA history,atrial fibrillation and age were independent prognostic factors for postoperative stroke,stroke or TIA history were the most significant factor associated with postoperative stroke (OR =13.01),followed by atrial fibrillation (OR =7.77) and age (OR =6.40).Conclusion Stroke or TIA history,atrial fibrillation,and age are independent prognostic factors for postoperative stroke.Hypertension,diabetes,and non-atrial arrhythmias during surgery are prognostic factors for postoperative stroke.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/72166
Appears in Collections:北京大学第三临床医学院_麻醉科_期刊论文

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作者单位: 1.100191,北京大学第三医院麻醉科
2.100191,北京大学第三医院临床流行病学研究中心
3.100191,北京大学第三医院神经内科
4.100191,北京大学第三医院骨科
5.100191,北京大学第三医院普外科
6.100191,北京大学第三医院危重医学科

Recommended Citation:
李刚,曲亦伸,李楠,等. 普通外科和骨科术后脑卒中预后因素的巢式病例-对照研究[J]. 中华医学杂志,2015,95(14):1088-1092.
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