外伤性急性弥漫性脑肿胀的相关危险因素分析

Risk factors for posttraumatic acute diffuse brain swelling

目的 通过对外伤性急性弥漫性脑肿胀的临床流行病学调查,探讨其相关危险因素及发病机制,为院前急救及后期救治提供依据.方法 对54例外伤性弥漫性脑肿胀（病例组）与270例同期未发生外伤性弥漫性脑肿胀（对照组）患者的性别、年龄、受伤至入院时间、着力部位、误吸、低血压、高血压病史、原发脑干伤、合并多发伤、颅底骨折等因素进行病例对照研究.结果 原发脑干伤、低血压、着力部位（枕部）、误吸、年龄等因素与外伤性弥漫性脑肿胀的发生密切相关.结论 原发脑干伤、低血压、着力部位（枕部）、误吸是外伤性急性弥漫性脑肿胀的危险因素；高龄是外伤性急性弥漫性脑肿胀的保护因素.

Objective To analyze the risk factors of posttraumatic acute diffuse brain swelling （PADBS）,explore its pathogenesis,and provide the evidence of pre- hospital medical care and sequent treatment through the epidemiological survey.Method Gender,age,time from injured to enter to hospital,force position,aspiration,hypotension,history of hypertension,primary brainstem injury,united injury,the presence or absence of skull base fracture were recorded and analyzed in 54 PADBS patients （ study group） and 270 patients without PADBS.Results Primary brainstem injury,hypotension,force position,aspiration,and age were closely correlated with the occurrence of PADBS.Conclusions Primary brainstem injury,hypotension,force position,and aspiration are the risk factors for PADBS,and agedness is a protective factor for PADBS.