外伤性蛛网膜下腔出血的相关因素分析

Analysis on relative factors of traumatic subarachnoid hemorrhage

目的:探讨和分析外伤性蛛网膜下腔出血(TSAH)在急性颅脑损伤中的发生特点和相关因素。方法:通过对我院2007年3月～2009年10月收治的326例颅脑损伤病人(伴有复合伤除外)的回顾性分析,根据入院时CT扫描结果确定有无TSAH,并分为有TSAH组和无SAH组,探讨TSAH与不同年龄、性别、致伤原因、GCS评分、CT评分、合并原发性脑损伤以及预后的关系。结果:本组147例发生TSAH(45.09%)。随着年龄的增加,TSAH的发生率明显增加;本组20岁以下和20～60岁的发生率分别为17%和66.6%;致伤原因中以车祸伤和高处坠落伤多见,分别为66.6%和14.2%。TSAH常合并的脑损伤是脑挫裂伤和硬膜下血肿(48.7%和42.9%);随着病情的加重,TSAH的发生率明显增加,预后越差。结论:TSAH在急性颅脑损伤中常见。伤情越重,发生率越高,预后越差。

Objective：To explore and analyze the occurrence characteristics and related factors of traumatic subarachnoid hemorrhage （TSAH） in acute traumatic brain injury. Methods：In our department between March 2007 to October 2,009,326 inpatients of head injury （associated with complex injuries excluded） were retrospectively analyzed. According to admission CT scan results to determine TSAH.The patients were divided into TSAH group and non-TSAH group. The relation of TSAH with different age,gender,injury cause,GCS score,CT score,complicating primary brain injury and prognosis was studied. Results：The 147 cases of TSAH occurred （45.09%）. With increasing age,TSAH was significantly increased. In the groups of 20 years of age and 20～60 year of age,the incidence were 17% and 66.6% respectively;car accident and falling from height were more common,accounting for 66.6% and 14.2% respectively. TSAH complicating brain injury was often brain contusion and subdural hematoma （48.7% and 42.9%）;as the disease condition increase;TSAH significantly increased with poor prognosis. Conclusion：TSAH is common in the patients with acute traumatic brain injury. The more severe injuries,higher incidence and worse the prognosis.