重型颅脑损伤患者的生存风险因素分析

Risk factors of living conditions of patients with severe craniocerebral injury undergoing operative treatment

目的探讨手术治疗重型颅脑损伤患者的生存状況及其影响因素。方法对我院收治的98例行去骨瓣减压术治疗的重型颅脑损伤患者的临床资料进行回顾性分析,根据术后扩展格拉斯哥预后评分(GOSE)分为预后良好组58例与预后不良组40例,对比两组的临床特点,并对预后因素进行单因素及多因素分析。结果两组患者年龄、入院瞳孔直径、受伤至手术时间、入院GCS评分及CT值等比较差异均有统计学意义(P<0.05);多因素回归分析显示,年龄、入院瞳孔直径、受伤至手术时间、入院GCS评分及CT值等是患者预后的显著影响因素(P<0.05);预后良好组的术后并发症发生率显著低于预后不良组,差异有统计学意义(P<0.05)。结论行手术治疗的重型颅脑损伤患者的生存状况较差,与年龄、入院瞳孔直径、受伤至手术时间、入院GCS评分及CT值等因素密切相关,应引起临床重视。

Objective To investigate the living conditions and its influence factors of patients with severe craniocerebral injury undergoing operative treatment. Methods The clinical data of 98 patients with severe cranioce- rebral injury who were treated by decompressive eraniectomy in our hospital were analyzed retrospectively. All the patients were divided into good prognosis group （58 cases） and poor prognosis group （40 cases） according to the postop- erative extension Glasgow outcome score （GOSE）. The clinical characteristics of two groups were compared, and its influence factors were analyzed by univariatc and multivariate logistic regression analysis. Results The difference in age, pupil diameter of admission, time interval from injury, GCS scores and CT number between the two groups were statistically significant （P〈0.05）. Multivariate Logistic regression analysis showed that age, pupil diameter of admission, time interval from injury, GCS scores and CT number were all the remarkable influence factors of the prognosis （P〈0.05）. The postoperative complication rate of good prognosis group was significantly lower than that.of poor prog- nosis group, and thedifference was statistically significant （P〈0.05）. Conclusion The living conditions of patients with severe craniocerebral injury treated by operative treatment is poor, which is related to age, pupil diameter of admission, time interval from injury, GCS scores and CT number closely, and close attention should be paid to it in clini- cal practice.