重型颅脑损伤患者死亡危险因素回归分析

Logistic analysis the risk factors of patients with severe craniocerebral injury

目的 探讨影响重型颅脑损伤患者死亡的危险因素。方法采用回顾性分析方法，对危险因素进行单变量和多变量Logistic回归分析，筛选主要危险因素。结果影响重型颅脑损伤患者死亡的主要危险因素有4种：格拉斯哥昏迷评分（GCS）低（OR=0．338；CI：0．176～0．649）、原发性脑干损伤及弥漫性轴索损伤（OR=3.048；CI：1．996～9．810）、双侧瞳孔散大（OR=2．263；CI：1．468～8．289）、中线移位〉0．5cm（OR=2．981；CI：1．795～8．350）。结论重型颅脑损伤患者死亡与多种因素有关，救治的关键在于早期诊断，早斯治疗，尽快减压。

Objective To discuss the risk factors which affect the patients with severe craniocerebral injury. Methods Risk factors were analyzed by univeriate regression analysis and multi veriable regression analysis, using retrospective methods to select primary dangerous factors. Results There were four risk factors that affected the patients with severe craniocerebral injury： low score of GCS （ OR = 0. 338; CI： 0. 176 - 0. 649）, primary injury of brainstem and diffuse injury of axons （ OR = 3. 048; CI ：1. 996 -9. 810）, dilating pupils of both eyes （ OR =2. 263 ; CI ： 1. 468 - 8. 289）, shift of midline 〉 0.5 cm （ OR = 2. 981 ; CI ： 1. 795 - 8. 350）. Conclusion Many factors affect the death of patients with severe craniocerebral injury and the key point of treatment is to diagnose,treat,and lower the intercranial pressure as early as possible.