摘要
目的探讨影响急性颅脑损伤早期预后的相关因素。方法收集2016-01～2017-12收治的264例中、重型颅脑损伤的临床资料,应用χ~2检验、t检验、单因素分析、多因素Logistic回归分析急性颅脑损伤患者早期死亡的危险因素。结果中型颅脑损伤死亡6例,死亡率为3. 77%(6/159);重型颅脑损伤死亡28例,病死率26. 67%(28/105)。单因素分析显示年龄、白细胞、凝血功能、GCS评分、瞳孔对光反应、运动评分、中线状态、环池状态、受伤类型与急性颅脑损伤患者的早期死亡相关(P <0. 05)。多因素Logistic回归分析显示年龄、白细胞、GCS评分、双侧瞳孔对光反应、运动评分、中线移位、环池状态、受伤类型是急性颅脑损伤患者早期死亡的危险因素(P <0. 05)。结论年龄> 55岁时,急性中、重型颅脑损伤患者的死亡风险显著增加,入院时白细胞计数越高患者的死亡风险越高。另外,低GCS评分、双侧瞳孔对光反应消失、刺激过伸和消失、中线移位、基地池受压、开放性颅脑损伤也是急性颅脑损伤患者早期死亡的危险因素。
Objective To investigate the early prognostic factors of acute craniocerebral injury.Methods The clinical data of 264 patients with moderate and severe craniocerebral injury were collected from January 2016 to December 2017.χ^2 test,t test,univariate analysis and multivariate Logistic regression were used to analyze the risk factors for early death in patients with acute craniocerebral injury.Results Six patients died of moderate craniocerebral injury,and 28 patients died of severe craniocerebral injury,and the fatality rate was 3.77%(6/159)and 26.67%(28/105),respectively.Univariate analysis indicated that age,leukocyte,coagulation function,GCS score,pupil response to light,motor score,midline state,cistern state,and injury type were correlated with early death in patients with acute craniocerebral injury(P<0.05).Multivariate Logistic regression analysis showed that age,WBC,GCS score,bilateral pupil response to light,motor score,midline shift,cyclopean status,and injury type were risk factors for early mortality in patients with acute craniocerebral injury(P<0.05).Conclusion At the age of above 55 years,the risk of death is significantly increased in patients with acute moderate and severe brain injury,and the higher the white blood cell count at admission is,the higher the risk of death is.Other risk factors for early mortality in patients with acute craniocerebral injury include low GCS score,bilateral pupillar light reflex disappear,stimulation overextention and disappearance,midline shift,basilar cistern compression,open craniocerebral injury.
作者
陈华辉
张刚利
张豪
张梦杰
王文雄
CHEN Huahui;ZHANG Gangli;ZHANG Hao;ZHANG Mengjie;WANG Wenxiong(Department of Neurology Surgery,People's Hospital Affiliated to Shanxi Medical University,Taiyuan 030001,China)
出处
《山西医科大学学报》
CAS
2019年第1期112-116,共5页
Journal of Shanxi Medical University
关键词
急性颅脑损伤
危险因素
预后
acute craniocerebral injury
risk factors
prognosis
