摘要
目的探讨急性颅脑创伤(TBI)患者颅内血肿体积的影响因素。方法回顾性分析2018年1—12月南京医科大学附属常州第二人民医院神经外科(60例)和江苏大学附属金坛人民医院神经外科(37例)收治的97例急性TBI患者的临床资料。采用秩和检验筛选患者颅内血肿体积的影响因素,并进一步建立多元逐步回归模型验证血肿体积的独立危险因素。结果单因素分析结果提示,性别、入院时格拉斯哥昏迷评分(GCS)和血浆纤维蛋白原水平与急性TBI患者的颅内血肿体积有关(均P<0.05)。不同年龄、致伤机制、意识状态(是否昏迷)、血压、血浆血红蛋白水平、血三酰甘油水平、凝血酶原时间(PT)、PT国际标准化比值、活化部分凝血活酶时间以及血浆D-二聚体水平的患者颅内血肿体积的差异均无统计学意义(均P>0.05)。Pearson相关分析结果显示,入院GCS与颅内血肿的体积呈负线性相关(r=-0.47,P<0.001)。多元线性回归分析结果显示,入院时血浆纤维蛋白原水平为颅内血肿体积的独立危险因素(t=-3.40,P<0.001)。结论入院时血浆纤维蛋白原水平较高的急性TBI患者具有更小的颅内血肿体积。
Objective To investigate the influencing factors of intracranial hematoma volume in acute brain trauma patients.Methods A retrospective study was conducted to analyze the clinical data of 97 patients with acute brain trauma who were admitted to Department of Neurosurgery,Changzhou No.2 People′s Hospital Affiliated to Nanjing Medical University(60 cases)and Department of Neurosurgery,Jintan People′s Hospital Affiliated to Jiangsu University(37 cases)from January 2018 to December 2018.First,rank sum test was used to screen candidate influencing factors of intracranial hematoma volume.Multiple linear regression was further performed to confirm the independent factors.Results Results of univariate analysis showed that gender,Glasgow coma scale(GCS)score and plasma fibrinogen level at admission were correlated with volume of intracranial hematoma in acute brain trauma patients(all P<0.05).There was no significant difference in the volume of hematoma among patients with different ages,trauma mechanisms,status of consciousness,values of blood pressure,plasma levels of hemoglobin,plasma levels of triglyceride,prothrombin time,international normalized ratios,activated partial thromboplastin time and plasma levels of D-dimer(all P>0.05).The result of Pearson correlation analysis implicated that GCS score at admission was negatively correlated with the volume of hematoma(r=-0.47,P<0.001).Multiple linear regression results demonstrated that plasma fibrinogen level was an independent influencing factor for the volume of hematoma in patients with acute brain trauma(t=-3.40,P<0.001).Conclusion Patients with acute brain trauma who have relatively higher plasma fibrinogen level at admission have smaller volume of intracranial hematoma.
作者
张斌
黄武
于震男
刘芳
Zhang Bin;Huang Wu;Yu Zhennan;Liu Fang(Department of Neurosurgery,Jintan People′s Hospital Affiliated to Jiangsu University,Changzhou 213000,China;Department of Neurosurgery,Changzhou No.2 People′s Hospital Affiliated to Nanjing Medical University,Changzhou 213000,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2020年第12期1256-1260,共5页
Chinese Journal of Neurosurgery
关键词
颅脑损伤
颅内出血
血肿体积
危险因素
血浆纤维蛋白
Craniocerebral trauma
Intracranial hemorrhages
Volume of hematoma
Risk factors
Plasma fibrinogen
