外伤性急性弥漫性脑肿胀相关因素分析

A Clinical Analysis of Related Factors for Posttraumatic Acute Diffuse Brain Swelling

目的分析探讨外伤性急性弥漫性脑肿胀（posttraumatic acute diffuse brain swelling,PADBS）发生的临床相关因素,为预防PADBS的发生提供相应的临床依据。方法对2006年3月～2013年11月天津市静海县医院脑外科收治的资料完整的颅脑外伤患者109例进行回顾性分析,其中伤后发生PADBS患者19例,作为病例组。另外90例未发生PADBS者作为对照组,采用单因素方差分析或卡方检验比较两组患者的各项临床相关因素有无差别,分析PADBS发生的相关因素。结果本组109例患者中发生PADBS19例,整体发生率为17.4%。单因素卡方检验显示病例组中受伤至治疗时间大于4小时（χ^2=5.89,P=0.02）、受伤后发生休克（χ^2=4.47,P=0.03）和原发性脑干损伤（χ^2=3.89,P=0.04）患者的比例显著高于对照组,且差异具有统计学意义。结论受伤至治疗时间延长、伤后发生休克及原发性脑干损伤可能是颅脑外伤患者发生外伤性急性弥漫性脑肿胀的危险因素。

Objective To assess the clinical ris factors for posttraumatic acute diffuse brain swelling（PADBS） in patients with traumatic brain injury.Method 109 subjects with traumatic brain injury from 2006 to 2012 were analyzed retrospectively in the Department of neurosurgery,Jinghai county hospital of Tianjin.Of the included 109 patients,19 subjects had the PADBS（case group） and other 90 subjects had no PADBS disease（control group）.The related clinical factors was evaluated between the two groups.And the chi-square was used to analysis the data.Result There were19 cases of PADBS of the 109 subjects include in this retrospective study.The overall incidence of PADBS was17.4%.Single factor chi-square were used to display the results cases to treatment time is more than 4 hours（χ^2=5.89,P=5.89）,after an injury occurred shock（χ^2=4.47,P=4.47） and primary brain stem injury（χ^2=3.89,P=3.89）.The proportion of patients is significantly higher than the control group,and the difference has statistical significance.Conclusion Patients with aspiration,hypotension and primary brainstem injury and delayed treatment were susceptible for PADBS,which should be pay much attention to.