颅脑损脑伤后早期癫痫发作危险因素的Logistic回归分析

Logistic Regression Analysis of Risk Factors Related to Early Posttraumatic Seizure

目的分析颅脑损伤后患者早期癫痫发作(EPTS)的危险因素。方法回顾性分析同济医院神经外科2003年1月至2008年1月收治的336例颅脑损伤患者的临床资料,对颅脑损伤后EPTS的相关临床因素进行单因素分析和Logistic回归分析。结果单因素分析结果显示:患者年龄、GCS评分、外伤后昏迷时间、硬脑膜完整性、有无颅内血肿、有无脑挫伤、血钠水平和有无酗酒史均是EPTS的危险因素(P<0.05),性别和治疗方式与EPTS相关性较小(P>0.05),颅脑损伤后EPTS的发生率为8.63%(29/336),患者年龄(OR=0.45802)、外伤后GCS评分(OR=0.870024)、外伤后昏迷时间(OR=4.160461)、硬脑膜完整性(OR=4.833046)和脑挫伤(OR=2.783133)均是外伤后EPTS发生的危险因素。结论患者年龄较小、伤后GCS评分较低、外伤后昏迷时间>30min、硬脑膜有破损和低钠血症均可以增加颅脑损伤后出现EPTS的危险性,此研究结果可为癫痫的防治提供参考。

Objective To analyze the risk factors related to early posttraumatic seizure （EPTS）. Methods A total of 336 patients with craniocerebral injury, who were treated in the Department of Neurosurgery of Tongji Hospital from January, 2003 to January, 2008, were investigated. Their full clinical data were collected. There was ETPS in 29 of the 336 patients 7 days after the cerebral trauma. The one-way ANOVA analysis and Logistic regression analysis of the risk factors related to EPTS were performed. Results One-way ANOVA analysis showed that the occurrence of EPTS was associated with patient＇ s age, GCS, duration of coma after the trauma, integrity of cerebral dura mater, intracrauial hematoma, cerebral contusion, blood sodium disorders and insobriety （P〈0.05）, and it was not associated with sex and treatment （P〉0.05）. Logistic regression showed that the risk factors related to EPTS included the patients＇ age （OR= 0.45802）, posttraumatic GCS （0R=0.870024）, duration of coma after the trauma （OR=4.160461）, integrity of cerebral dura mater （OR= 4.833046） and cerebral contusion （OR=2.783133）. Conclusions EPTS easily occurs in the patients with craniocerebral injury who are younger and have lower posttraumatic GCS, coma for more than 30 minutes after the trauma, rupture of cerebral dura mater and hyponatremia. The present results is helpful to prevention and treatment of EPTS in the patients with craniocerebral injury.