吴昆鹏 1陈莹 2言彩红 1黄治家 1桂培根 1吴正茂 1张群峰 1肖宏1
作者信息
- 1. 421001 湖南省衡阳市，南华大学附属第二医院重症医学科
- 2. 421001 湖南省衡阳市，南华大学附属第二医院麻醉科
- 折叠
摘要
Abstract
Objective To investigate the survival situation in patients with persistent vegetative state( PVS)after brain trauma and to explore the factors associated with their prognosis. Methods From January 2009 to June 2014,we selected 196 patients with PVS(108 were due to brain trauma and 88 due to stroke)admitted to Department of Intensive Care Unit,the Second Hospital,University of South China as the subjects of this study. We collected the clinical data of the subjects and gave them a follow - up,the latter including the following:length of hospital stay,alimentation mode,family economic conditions, family care status,incidence of lung infection,nutritional status,survival state and so on. The survival rate of patients was analyzed. And the factors influencing the prognosis of PVS patients were analyzed by Cox proportional hazards regression model. Results The median survival time was 12. 5 months,1 - year overall survival rate was 53. 5% and 2 - year overall survival rate was 20. 0% for the 196 PVS patients. No difference in the prognosis was observed between PVS patients with different gender and type of disease(P > 0. 05). Age,length of hospital stay,stomach colostomy,family economic conditions,family care status, incidence of lung infection,nutritional status were the factors causing the statistically significant difference in the prognosis between the PVS patients(P < 0. 05). Results of Cox proportional hazards model analysis demonstrated that advanced age,no stomach colostomy,poor family care,lung infection and poor nutrition status were risk factors for the poor prognosis of PVS patients(P < 0. 05). According to the number of poor prognosis factors,the patients were divided into:group with 0 or 1 poor prognosis factor(109 cases,the median survival time was 18. 9 months;1 - year,2 - year survival rates were 80. 5% , 30. 0% ,respectively);group with 2 or more poor prognosis factors(87 cases,the median survival time was 7. 8 months;1 -year,2 - year survival rates were 14. 8% ,0,respectively ),which showed that the differences in the 1 - year,2 - year survival rate between the two groups were statistically significant( χ2 = 92. 781,P < 0. 001;χ2 = 26. 073,P < 0. 001). Conclusion Almost 50. 0% of the PVS patients died within 1 year. Advanced age,no stomach colostomy,poor family care, lung infection,poor nutritional status are the independent adverse factors influencing the prognosis of PVS patients.关键词
持续植物人状态/预后/危险因素Key words
Persistent vegetative state/Prognosis/Risk factors分类
医药卫生
