影响颅脑损伤后精神障碍的相关危险因素分析

Analysis of the associated risk factors for the mental disorders caused by brain injury

目的探讨影响颅脑损伤后精神障碍的相关危险因素。方法收集我院2012年1月至2015年1月我院收治的187例颅脑损伤患者的临床资料,按照是否出现精神障碍将所有患者分为病例组(精神障碍组)和对照组(非精神障碍组),比较两组患者相关临床资料的差异,并利用Logistic回归分析探讨影响颅脑外伤后精神障碍的相关危险因素。结果 187例颅脑损伤患者出现75例精神障碍(发病率40.1%);单因素分析提示两组患者在教育程度、受伤至急救时间、GCS评分≤8分、颅内血肿、额叶损伤、损伤范围、低氧血症、伤后昏迷存在统计学差异(P<0.05);经过多因素Logistic回归分析最终筛选出GCS评分≤8分、颅内血肿、额叶损伤、损伤范围、低氧血症是颅脑损伤后发生精神障碍的高危因素。结论颅脑损伤后精神障碍发生率较高且受到多种因素的影响,临床中应当重视此类高危因素,以制定相关干预措施降低精神障碍发生率。

Objective To investigate the associated risk factors for the mental disorders caused by brain inju- ry. Methods Clinical data of 187 patients with brain injury were collected from January 2012 to January 2015 in our hospital, all patients were divided into case group （mental disorder group） and control group （ non-mental dis- orders group） according to mental disorders; compared the difference between the two groups of patients with clini- cal information, and Logistic regression analysis was used to study the associated risk factors for the mental disorders caused by brain injury. Results 75 patients out of 187 patients with brain injury showed mental disorders （the in- cidence was 40. 1%）. Single factor analysis showed that there were statistical differences in patients＇ education degree, injury to the emergency time, GCS score ≤8, intraeranial hematoma, frontal lobe injury and zone of injury, hypoxemia, coma after injury, between the two groups （P〈0. 05） ; muhivariable Logistic regression analysis finally showed that GCS score ≤8, intraeranial hematoma, frontal lobe injury and zone of injury, hypoxe/nia were higher risks of mental disorder caused by brain injury. Conclusion Mental disorder caused by brain injury has high inci-dence and affected by many risk factors, such should be paid great attention to risk factors in the clinical work so as to establish relevant interventions to＇ reduce the incidence of mental disorders caused by brain injury.