外伤性丘脑基底节区血肿的临床预后分析

Clinical prognostic analysis of patients with traumatic basal ganglia hematoma

目的探讨外伤性丘脑基底节区血肿的相关危险因素,为早期诊断及治疗提供依据。方法收集杭州师范大学医学院附属余杭医院自2000至2009年收治的外伤性丘脑基底节区血肿患者57例,根据预后分为两组,预后不良组和预后良好组,多因素回归分析相关因素对预后的影响。结果单因素分析显示血肿大小、入院GCS评分、合并其他颅内出血、瞳孔变化、PLT对外伤性丘脑基底节区血肿的预后的影响具有统计学意义(P<0.05)。多因素logistic回归分析显示血肿大小、入院GCS评分、瞳孔变化是外伤性丘脑基底节区血肿的预后的独立危险因素。结论对于血肿量大、入院GCS评分较低、瞳孔有变化者常提示预后不良,因此要及时观察病情变化,早期救治,对提高外伤性丘脑基底节区血肿的预后有着积极的作用。

Objective To investigate prognostic risk factors of patients with traumatic basal ganglia hematoma for early diagnosis and treatment.Methods 57 cases of patients with traumatic basal ganglia hematoma admitted to the Affiliated Yuhang Hospital of Hangzhou Normal University college of medicine from 2000 to 2009 were analyzed.Patients were divided into favourable and unfavourable groups according to prognosis.Prognostic risk factors were analyzed with multivariate logistic regression analysis.Results Single-factor analysis revealed that hematoma size,GCS score on admission,pupil change,complicated intracranial hemorrhage and PLT were singnificantly different.（P0.05）.Multivariate logistic regression analysis of results showed that hematoma size,GCS score on admission,pupil change were the independent risk factors.Conclusion Patients with huge haematoma,lower GCS score or pupil change indicated unfavourable prognosis.Thus,close illness observation and early management are suggested to improve the prognosis of traumatic basal ganglia hematoma.