外伤后急性弥漫性脑肿胀的相关危险因素及护理介绍.doc

外伤弥漫性脑肿胀的危险因素张春雷 王玉海【摘要】 目的 通过对外伤急性弥漫性脑肿胀的临床流行病学调查，相关危险因素，提供依据。方法 外伤急性弥漫性脑肿胀性别、年龄、受伤至入院时间、着力部位、误吸、低血压、高血压病史、原发脑干伤、合并多发伤、颅底骨折Logistic回归分析。结果 原发脑干伤、低血压、着力部位（枕部）、误吸是的危险因素高龄是的保护因素。结论【关键词】 外伤性急性弥漫性脑肿胀危险因素；Logistic； Risk factors and nursing interventions for Posttraumatic Acute Diffuse Brain Swelling WU You-ping, ZHANG Chun-lei, WANG Yu-hai, LIU Qi-qin.Craniocerebal injury cure center of PLA, Department of Neurosurgy, 101st Hospital of PLA, Wuxi 214044,China 【Abstract】 Objective To analyze the risk factors of posttraumatic acute diffuse brain swelling (PADBS), provide the evidence corresponding care strategies through the epidemiological survey. Methods Ten possible risk factors of posttraumatic acute diffuse brain swelling ( Gender, age, time from injured to enter hospital, force position, aspiration, hypotension, history of hypertension, primary brainstem injury, united injury, the presence or absence of basicranial fracture) were analyzed by logistic regression analysis. Results Primary brainstem injury，hypotension, force position, aspiration, and age were closely correlated with the occurrence of PADBS . Conclusion Nurses should concern about the risk factors associated with acute traumatic diffuse brain swelling. The incidence of acute traumatic diffuse brain could be reduced through monitoring the respiratory and circulatory system, reducing aspiration, and developing the correct fluid therapy. 【Key words】Posttraumatic acute diffuse brain swellingRisk factors；Logistic； 外伤性急性弥漫性脑肿胀（PADBS ）是指外伤后脑组织广泛肿大或膨胀，CT表现为双侧或单侧大脑半球肿胀，可单独存在或与各种类型颅脑损伤同时并存，是影响脑外伤患者预后的重要因素之一多数发生于伤后4～14小时最早可发生在伤后20～30分钟。国内外目前对的研究多集中于发病机制及预后的探讨，而有关PADBS的临床流行病学调查及相关危险因素研究，国内外报道。现例患者的临床资料进行回顾性分析，PADBS的危险因素，并为临床提供依据。 资料与方法 一般资料2007年1月2011年月收治的颅脑伤中发生PADBS的例患者及同期入院未发生PADBS的例患者为研究对象。PADBSCT诊断标准确诊的例患者（其中男例，女例，年龄平均39岁2-68岁GCS评分3-5分例、6-8分例、9-12分例、13-15分例）作为病例组，；PADBS的颅脑损伤患者随机选择例（男2例，女例，年龄平均4岁4-82岁GCS评分3-5分例、6-8分例、9-12分例、13-15分1例）作为对照组。共计3例。 CT动态扫描观察根据文献资料及临床经验选择可能的危险因素：性别；年龄；受伤至入院的时间；着力部位；误吸；低血压；高血压病史；原发脑干伤