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目的 :探讨脑内疾病患者在稳定或恢复期并发消化道出血的原因及预防抢救措施。方法 :对 52例ICU重度脑内疾病患者做回顾性分析。结果 :稳定期或恢复期并发消化道出血 18例患者中 ,出现脑并发症 10例、难治性肺炎 16例、长期肠外营养 9例、MODS 14例 ,血糖持续为 10 .2±2 .8mmol/L ;与非出血组比较 ,在血糖水平方面两组差异有非常显著性 (P <0 .0 0 1) ,两组在脑并发症方面有显著性差异。在难治性肺炎、长期肠外营养、并发MODS等两组均有明显差异。结论 :脑内疾病患者在稳定期或恢复期并发消化道大出血 ,是与脑并发症、高血糖、难治性肺炎、长期肠外营养以及并发MODS有关 ,预后不良。
Objective: To investigate the causes and preventive measures of patients with intracerebral diseases complicated with gastrointestinal bleeding in stable or recovery period. Methods: 52 cases of severe intracerebral hemorrhage in ICU were retrospectively analyzed. Results: In 18 patients with stable or concomitant gastrointestinal bleeding, there were 10 cases of brain complications, 16 cases of refractory pneumonia, 9 cases of chronic parenteral nutrition, 14 cases of MODS, and the duration of blood glucose was 10.2 ± 2. 8mmol / L; compared with non-hemorrhagic group, there was significant difference in blood glucose level between the two groups (P <0.01). There was significant difference between the two groups in cerebral complications. In refractory pneumonia, long-term parenteral nutrition, concurrent MODS and other two groups were significantly different. Conclusion: Patients with intracerebral diseases complicated with gastrointestinal hemorrhage in stable or convalescent stage are associated with brain complications, hyperglycemia, refractory pneumonia, long-term parenteral nutrition and complicated MODS. The prognosis is poor.