急性外伤性颅内血肿开颅血肿清除术后迟发血肿相关因素的Logistic回归分析

Binary logistic analysis of related factors for the delayed postcraniotomy intracranial hematoma

目的研究急性外伤性颅内血肿开颅血肿清除术后迟发血肿的相关因素。方法收集记录271例急性外伤性颅内血肿开颅手术治疗患者的临床资料,对相关因素进行二分类单因素及多因素Logistic回归分析。结果 52例患者术后迟发血肿。单因素回归分析得到持续昏迷、Babinski征阳性、颅骨骨折等12个变量有统计学意义(P<0.05),多因素回归分析得到血浆凝血酶时间(P=0.027,OR=1.154)、Babinski征阳性(P=0.000,OR=4.107)、颅骨骨折(P=0.000,OR=4.980)为术后迟发血肿的危险因素,手术时机(P=0.016,OR=0.91)为保护因素。结论对入院时Babinski征阳性、血浆凝血酶时间明显延长、合并颅骨骨折且早期急诊手术治疗的重型颅脑损伤患者在术后早期需警惕迟发血肿的发生。

Objective To investigate the related factors for delayed postcraniotomy intracranial hematoma. Methods Clinical data were collected from 271 hospitalized patients admitted from Jan. 2007 to Apr. 2011, the related factors of the postcraniotomy intracranial hematoma were statistically analyzed by univariate and multivariate binary Logistic regression. Results 52 patients had delayed postoperative traumatic intracra- nial hematoma. 12 factors such as continuing coma, positive Babinski sign, skull fractured had significant differences （P〈0.05）. By multivariate analy- sis in which showed that the thrombin time （P=0.027, OR=1.154）, positive Babinski sign （P=0.000, OR=4.107）, skull fracture （P=0.O00, OR=4.980） were the independent risk factors for delayed postcraniotomy intracranial hematoma, while surgical opportunity was the protective factor （P=0.016, OR=0.91）. Conclusion Severe traumatic brain injury patients treated by early operation, with continuing coma, accompanied with positive Babinski sign as well as prolonged thrombin time were probably to have postcraniotomy intracranial hematoma.