重症监护自发性脑出血患者的特征、治疗方法和预后评估:一项回顾性研究

Serpil Ekin, Asiye Demirel, İlkay Ceylan, Şermin Eminoğlu, Şeyda Efsun Özgünay
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摘要

目的:自发性脑出血(SIH)是一种常见的脑血管疾病,死亡率高,临床预后差。本研究旨在探讨SIH患者的基本特征,他们的治疗实践和早期结果,以提供一个全面的概述。方法:经我院伦理委员会批准,对2017 - 2021年患者病历进行审查。记录和分析符合研究标准的患者的人口统计数据、在重症监护病房(ICU)应用的外科和药物治疗以及即时临床结果数据。结果:本研究共纳入153例患者。SIH患者的死亡率为53.59%。研究发现,死亡人群的平均年龄值更高。在这些患者中,“昏厥”作为初始症状更为常见,而“局灶性神经功能缺损”则不太常见。格拉斯哥昏迷评分(GCS)中位数较低,急性生理和慢性健康评估II (APACHE II)评分较高。我们注意到,在死亡人群中,新鲜冷冻血浆(FFP)使用率较高,而口服抗高血压药物的使用率较低。33.33%的患者转院(神经内科或神经外科),11.76%的患者接受姑息治疗,1.31%的患者接受家庭护理。结论:SIH患者死亡率极高,重症监护治疗应按现行指南进行。需要更全面的研究来规范适当的治疗方法。除了适当的治疗策略以降低死亡率外,确定并支持存活患者的长期治疗和康复需求也具有重要意义。
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Assessing characteristics, treatment approaches, and outcomes of spontaneous intracerebral hemorrhage patients in intensive care: a retrospective study
Aims: Spontaneous intracerebral hemorrhage (SIH) is a common cerebrovascular disease associated with high mortality and poor clinical outcomes. This study aimed to investigate the fundamental characteristics of patients with SIH, their treatment practices, and early results to provide a comprehensive overview. Methods: Patient records from 2017 to 2021 were reviewed following approval from the ethics committee of our hospital. Demographic data, surgical and medical treatments applied in the intensive care unit (ICU), and immediate clinical outcome data of patients meeting the study criteria were recorded and analyzed. Results: A total of 153 patients were included in this study. The mortality rate in SIH patients was identified as 53.59%. The mean age value of those who died was found to be higher. In these patients, "fainting" as the initial symptom was found to be more common, while "Focal Neurological Deficits" were less common. A lower median Glasgow Coma Scale (GCS) and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were also observed. It was noted that the fresh frozen plasma (FFP) usage rate was higher, whereas the usage rate of oral antihypertensives was lower in those who died. It was determined that 33.33 of patients, 33.33% were transferred to a service (neurology or neurosurgery), 11.76% received palliative care, and 1.31% received home care. Conclusion: The mortality rate of patients with SIH is extremely high, and treatment in intensive care should be conducted according to current guidelines. More comprehensive studies are needed to standardize the appropriate treatment approaches. Alongside suitable treatment strategies to reduce mortality, identifying and supporting surviving patients' long-term treatment and rehabilitation needs are of great significance.
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