外伤性重型颅脑损伤并发迟发性颅内血肿预后相关影响因素分析.pdfVIP

《中国医学前沿杂志 （电子版）》2017 年第9 卷第9 期 ● ●  83  论著  DOI ：10.12037/YXQY.2017.09-20 外伤性重型颅脑损伤并发迟发性颅内血肿 预后相关影响因素分析 宋雅婷 （四川大学华西医院　神经综合科，成都　61004 1） 【摘要】目的 分析影响外伤性重型颅脑损伤并发迟发性颅内血肿患者预后的相关因素，为改善患者 预后提供参考依据。方法 回顾性分析本院2013 年7 月至2016 年7 月收治的161 例外伤性重型颅脑 损伤并发迟发性颅内血肿患者的临床资料，按照预后质量，将恢复良好/ 中度残疾者纳入预后良好组， 将重度残疾/ 植物生存/ 死亡者纳入预后不良组，计算患者预后不良率并比较两组患者基线资料，将 存在统计学差异的因素纳入多因素Logistic 回归分析，分析影响外伤性重型颅脑损伤并发迟发性颅内 血肿患者预后的危险因素。结果 161 例患者中，47 例预后不良 （29.19% ）。多因素Logistic 回归分 析显示，年龄≥60 岁、减速伤、有合并伤、有并发症、多发性血肿、外伤性重型颅脑损伤发病后格 拉斯哥昏迷评分 （Glasgow coma score ，GCS）≥13 分、迟发性颅内血肿发病后GCS ≥13 分及迟发 性颅内血肿出血量＞60 ml 是影响外伤性重型颅脑损伤并发迟发性颅内血肿患者预后的独立危险因素 P （ ＜0.05 ）。结论 年龄、颅脑损伤严重程度、受伤性质及血肿类型均可影响外伤性重型颅脑损伤并 发迟发性颅内血肿患者的预后，明确患者病情程度并注重并发症的处理，对降低患者病死率和病残率 具有重要意义。 【关键词】外伤 ；重型颅脑损伤 ；迟发性颅内血肿 ；相关因素；预防 Analysis of prognostic factors of delayed intracranial hematoma after severe traumatic brain injury SONG Ya-ting (Department of Nerve General, West China Hospital, Sichuan University, Chengdu 61004 1, China) Corresponding author: SONG Ya-ting, E-mail:1@ Abstract Objective 【 】 　To analyze the related factors influencing the prognosis of patients with delayed intracranial hematoma (DTICH) after traumatic severe traumatic brain injury (sTBI), and to provide reference for improving the prognosis of patients with DTICH. Method　161 patients with DTICH after sTBI in our hospital from July 20 13 to July 20 16 were divided into groups according to the quality of prognosis. The patients with good/moderate disability were included in good prognosis group, and the ones with severe disability/plant survival/death were included in poor prognosis group. The rate of poor prognosis of the two groups were calculated and the baseline data were compared. Multivar