A Retrospective Study On Risk Factors And TCM Syndromes Of Sepsis Cerebral Hemorrhage Postoperative Perioperative

Objective1. To analyse the possible risk factors of sepsis cerebral hemorrhage postoperative peri operative, providing a theoretical basis for the prevention and treatment of early clinical sepsis.2. From the point of view of syndrome elements, to analyse the characteristic of syndrome elements that perioperative cerebral hemorrhage merge sepsis, to sum up the distribution of its syndrome elements, providing a scientific basis of syndromes for the diagnosis and treatment of cerebral hemorrhage merge sepsis.Methods1. Literature search and analysis, preliminary analysis of cerebral hemorrhage perioperative sepsis possible risk factors and distribution characteristics of TCM syndrome elements, developed clinical cases collected tables. A retrospective survey of clinical research methods were included 60 cases of cerebral hemorrhage patients, including 19 cases of traumatic brain hemorrhage, spontaneous intracerebral hemorrhage is 41 cases. According to the 2012 diagnostic criteria of sepsis guidelines, perioperative sepsis complicated by a total of 36 cases, which killed a total of 12 cases of patients (excluded families abandon related deaths).2. General information on the requirements of Table. The reference collection of cases, the collection included cases, clinical symptoms, signs, prognosis, surgery-related information and some laboratory test results, specifically including ICU length of stay, indwelling endotracheal intubation days, indwelling catheter days, a major number of underlying disease, bleeding way, the prognosis, PCT, CRP, etiology inspection and other indicators. Then extract some of the factors used to analyze brain hemorrhage perioperative sepsis possible risk factors.3. Summary and analysis included cases of traditional Chinese medicine syndrome elements distribution by SPSS statistical software for perioperative cerebral hemorrhage Sepsis Syndrome Factor composition were analyzed statistically.Results1. The study included 60 cases of cerebral hemorrhage patients, including total of 36 cases of patients with perioperative sepsis (sepsis group), a total of 24 cases (non-sepsis group) is not complicated by sepsis patients. In both groups between age, gender, no significant difference in bleeding way. Of perioperative cerebral hemorrhage in patients with sepsis-related risk factors Logistic regression analysis showed that patients with indwelling endotracheal intubation days, indwelling catheter days, ICU length of stay are correlated with perioperative sepsis, statistical results suggest that the regression coefficients are positive, it can be considered the incidence of sepsis and the above three factors into normality related changes, suggesting that these three factors for perioperative cerebral hemorrhage complicated by sepsis possible risk factors.2. It included 60 patients on TCM syndrome factors analysis, found that regardless of whether cerebral hemorrhage after surgery are merged with sepsis, syndrome of intermingled deficiency and excess is more common. Syndrome of intermingled deficiency and excess in sepsis group accounted for 50%, empirical accounting for 36.1%, deficiency accounted for 13.9%; non-sepsis group, Syndrome of intermingled deficiency and excess accounted for 66.7%, empirical accounting for 8.3%, deficiency accounted for 25%. Sepsis group: deficiency:the deficiency syndrome share up 60.9%, followed by the Yang deficiency(39.1%), Qi deficiency syndrome(4.3%); in the empirical, fiery certificate(87.1%), stasis syndrome(83.9%), phlegm syndrome(67.7%) more common, followed respectively Fushi (48.4%), wet stagnation (12.9%), syndrome of stagnation of Qi(3.1%). Non-sepsis group:in deficiency:Yang deficiency accounted for 59.1%, followed by the Ying deficiency syndrome(36.3%), Qi deficiency syndrome (9.1%); in the empirical, fiery certificate (83.3%), phlegm syndrome (66.7%), blood stasis syndrome (61.1%) more common, followed by the Fushi(27.8%), wet stagnation(11.1%). Comparison group consisting of sepsis and non-sepsis group TCM syndrome elements, using the chi-square test, the results suggest the TCM elements between the two groups constitute no significant difference.Conclusion1. The retention time of intubation, indwelling catheter time, ICU length of stay were cerebral hemorrhage perioperative risk factors may be complicated by sepsis. Therefore, for patients with cerebral hemorrhage, should be prepared to pipeline-related infection prevention, strengthen the primary disease treatment, timely review of PCT, CRP, etiology and other laboratory parameters to improve postoperative sepsis diagnosis rate, reasonable the use of anti-infective drugs, in order to reduce mortality in patients with postoperative sepsis.2. Cerebral hemorrhage in patients with sepsis and postoperative treatment of traditional Chinese medicine, Chinese medicine treatment principles should be noted that both Quxie and tonic, in deficiency note warming Yang and Qi may be appropriate. Empirical category "blood circulation", "heat". If the merger bowel gas barrier, may give Relaxing tune bowel syndrome therapies, topical and enema with Chinese characteristics and so on.3. Cerebral hemorrhage patients with sepsis in critical condition with a high mortality characteristics, possible risk factors for sepsis and corresponding treatment can be carried out, such as the prevention of ventilator-associated pneumonia, nutritional support etc; also can be combined with traditional Chinese medicine and Chinese medicine diagnosis and treatment outside of therapy, so that integrative medicine, in order to reduce the incidence and mortality of postoperative sepsis.