摘要
目的探讨影响颅脑创伤患者远期预后的危险因素,为临床防控提出参考措施。方法以山西医科大学第一医院2017年6月—2018年5月收治的147例颅脑创伤患者为研究对象,收集其相关临床资料。主要研究终点为患者伤后6个月的预后转归,采用电话随访。根据患者随访终点的预后,依据格拉斯哥预后量表(Glasgow outcome scale,GOS)评分分为预后良好组(GOS评分4~5分)和预后不良组(GOS评分1~3)分;对可能影响预后的因素进行分析。结果至随访终点,预后良好组患者111例(75.5%),预后不良组患者36例(24.5%)。单因素分析结果显示,不良预后的发生率在年龄、受伤至就诊时间、脑疝、合并四肢长骨骨折、手术、二次手术、血红蛋白量、血小板计数、格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分中的差异均有统计学意义(P<0.05-0.001)。多因素Logistic回归分析显示,年龄、脑疝、合并四肢长骨骨折、GCS评分、血红蛋白量、血小板计数是影响颅脑创伤患者远期预后的危险因素(P<0.05-0.001)。结论有多种因素会影响颅脑创伤患者的远期预后。入院时准确评估GCS评分、监测相关生化指标可在一定程度上评估患者远期预后;及早进行临床干预,可降低患者远期不良预后的风险。
Objective To explore the risk factors affecting the long-term prognosis of patients with traumatic brain injury,and to provide reference,prevention and control measures for clinical research.Methods Sixty patients with traumatic brain injury admitted to the First Hospital of Shanxi Medical University from April 2018 to August 2018 were enrolled in the study.Relevant clinical data were collected.The primary end point was the patients prognosis after 6 months,followed by telephone.According to the prognosis of the follow-up end point,the Glasgow Outcome Scale(GOS)was divided into a good prognosis group(GOS 4-5 points)and a poor prognosis group(1-3)points.Factors that may have an impact were analyzed.Results At the end of follow-up,111 patients(75.5%)had a good prognosis and 36(24.5%)had a poor prognosis.Univariate analysis showed that the incidence of adverse prognosis was statistically significant in terms of age,injury to treatment time,cerebral palsy,combined long bone fractures,surgery,secondary surgery,hemoglobin,platelet count,and GCS score(P<0.05-0.001).Multivariate logistic regression analysis showed that age,cerebral palsy,combined with long bone fractures,GCS score,hemoglobin,and platelet count were risk factors for long-term prognosis in patients with traumatic brain injury(P<0.05-0.001).Conclusions A variety of factors can affect the long-term prognosis of patients with traumatic brain injury.Accurate assessment of GCS and monitoring of biochemical indicators at admission can assess the long-term prognosis of patients to a certain extent,and early clinical intervention to reduce the risk of long-term poor prognosis.
作者
张彬
毛小静
冯杰
ZHANG Bin;MAO Xiao-jing;FENG Jie(Department of Emergency,Shanxi Medical University First Hospital,Taiyuan 030001,China)
出处
《临床神经外科杂志》
CAS
2020年第1期71-76,共6页
Journal of Clinical Neurosurgery
基金
睿E急诊医学研究专项基金(R2018034)
关键词
颅脑创伤
远期预后
因素分析
craniocerebral trauma
long-term prognosis
factor analysis
