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中华脑血管病杂志(电子版) ›› 2020, Vol. 14 ›› Issue (04) : 209 -216. doi: 10.11817/j.issn.1673-9248.2020.04.005

所属专题: 经典病例 文献

临床研究

综合医院院内新发卒中的临床特征——附116例资料分析
郑静维1, 彭斌2,()   
  1. 1. 100730 北京协和医院神经内科;100062 北京市普仁医院老年科
    2. 100730 北京协和医院神经内科
  • 收稿日期:2020-06-01 出版日期:2020-08-01
  • 通信作者: 彭斌
  • 基金资助:
    国家重点研发计划(2016YFC0901004); 北京市卫生局区县级医院专业骨干培训项目资助

Clinical characteristics of in-hospital stroke in general hospitals: analysis of 116 cases

Jingwei Zheng1, Bin Peng2()   

  1. 1. Department of Neurology, Peking Union Medical College Hospital, Beijing 100730, China; Department of Geriatrics, Beijing Puren Hospital, Beijing 100062, China
    2. Department of Neurology, Peking Union Medical College Hospital, Beijing 100730, China
  • Received:2020-06-01 Published:2020-08-01
  • Corresponding author: Bin Peng
  • About author:
    Corresponding author: Peng Bin, Email:
引用本文:

郑静维, 彭斌. 综合医院院内新发卒中的临床特征——附116例资料分析[J/OL]. 中华脑血管病杂志(电子版), 2020, 14(04): 209-216.

Jingwei Zheng, Bin Peng. Clinical characteristics of in-hospital stroke in general hospitals: analysis of 116 cases[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2020, 14(04): 209-216.

目的

分析综合医院内非卒中原因住院患者在住院期间发生卒中的科室分布及可能的原因,为制定院内卒中预防策略提供参考信息。

方法

回顾性分析2009年1月至2012年9月期间在北京协和医院内非神经内科、非卒中原因住院期间发生卒中的患者临床资料,分析科室分布、患者性别、年龄、卒中类型、发生及确诊时间、危险因素、诱因、临床表现、治疗和结局等特点。

结果

院内卒中共116例,男性多于女性(1.19∶1),平均年龄(56.0±17.7)岁,以缺血性卒中为主(60.34%,70/116),主要分布于血液内科20例(17.24%),神经外科15例(12.94%),急诊综合、内科重症监护室各8例(6.90%),普通内科、心内科各7例(6.04%),呼吸内科6例(5.18%),免疫内科、肾内科、泌尿外科、重症医学科各5例(4.31%)。61.21%发生在住院7 d以后,多为安静起病,以肢体无力/麻木或意识障碍为首发症状。常合并多种卒中危险因素,缺血性卒中常见原因有:心脏疾病、血压过低、围手术期、感染、凝血功能异常等;出血性卒中常见原因有:凝血功能障碍、围手术期、血压升高、血液透析等。院内卒中总体结局不佳,院内缺血性卒中溶栓治疗率低(2.86%,2/70)。

结论

综合医院院内卒中发病因素多种多样,与患者的基础疾病密切相关,及时全面评估患者的脑血管病危险因素,并做针对性处理,避免诱发因素,对预防院内卒中具有十分重要的意义。

Objective

To explore the causes and mechanisms of stroke in non-stroke inpatients during hospitalization in general hospitals, and to provide reference information for the development of in-hospital stroke prevention strategies.

Methods

We retrospectively analyzed the clinical data of in-hospital stroke patients who were admitted for other non-stroke diseases in Peking Union Medical College Hospital from January 2009 to September 2012. The characteristics of department distribution, sex, age, stroke type, occurrence and diagnosis time, risk factors, causes and inducements, clinical manifestations, treatment and outcome were analyzed.

Results

There were 116 cases of stroke occurred in hospital, and there were more males than females (1.19:1), with an average age of (56.0±17.7) years. Ischemic stroke was the most common type of stroke (60.34%, 70/116). The in-hospital stroke occurred mainly in Department of Hematology(20, 17.24%), Neurosurgery (15, 12.94%), Emergency Comprehensive Ward (8, 6.90%), Internal Medicine ICU (8, 6.90%), General Internal Medicine (7, 6.04%), Cardiology (7, 6.04%), Respiratory Medicine (6, 5.18%), Immunology (5, 4.31%), Nephrology (5, 4.31%), Urology (5, 4.31%) and ICU (5, 4.31%). 61.21% of the stroke occurred after 7 days of hospitalization, often in resting state, with weakness or numbness of limbs or disturbance of consciousness as the first symptoms. The patients were often complicated with several risk factors of stroke. The common causes of ischemic stroke included heart disease, hypotension, perioperative period, infection, coagulation dysfunction, etc. The common causes of hemorrhagic stroke included coagulation dysfunction, perioperative period, hypertension, hemodialysis, etc. The overall outcome of in-hospital stroke was poor, and the rate of thrombolytic treatment of ischemic stroke was low (2.86%, 2/70).

Conclusion

There are many kinds of risk factors for stroke in general hospitals, which are closely related to patients' comorbidity. Timely and comprehensive assessment of risk factors of cerebrovascular disease, targeted treatment, and avoidance of precipitating factors, are of great importance for stroke prevention in hospitals.

表1 院内卒中患者年龄分布情况
表2 院内卒中发生的科室分布情况
表3 院内卒中危险因素分布表[例(%)]
表4 院内卒中患者临床表现情况[例(%)]
表5 院内卒中患者临床结局[例(%)]
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