儿童创伤性脑梗死恢复的影响因素以及死亡的危险因素探讨

Discussion on influencing factors of recovery and risky factors of death in children with traumatic cerebral infarction

目的探讨儿童创伤性脑梗死恢复的影响因素以及死亡的危险因素。方法对66例创伤性脑梗死患儿的临床资料进行回顾性分析。结果 66例创伤性脑梗死患儿中,死亡12例(18.2%),存活54例(81.8%),包括植物人状态6例(9.1%)。54例创伤性脑梗死存活患儿恢复时间的影响因素为大面积脑梗死、感染、复合伤(OR=2.903,OR=2.092,OR=2.859;均P<0.05)。与创伤性脑梗死存活患儿比较,死亡患儿入院时GCS评分明显降低,大面积脑梗死、复合伤、低血压或休克、脑疝、癫痫的比例明显增加,脱水药物的使用尤其是大剂量使用的比例明显增加(均P<0.05)。多因素Logistic回归分析发现,创伤性脑梗死患儿死亡的独立危险因素分别为入院时GCS评分降低、复合伤、低血压或休克(均P<0.05)。结论影响儿童创伤性脑梗死恢复时间的因素为大面积脑梗死、感染、复合伤。入院时GCS评分低、复合伤、低血压或休克是儿童创伤性脑梗死死亡的独立危险因素。

Objective To observe the influencing factors of recovery and the risky factors of death in children with traumatic cerebral infarction. Methods The clinical data of 66 children with traumatic cerebral infarction was retrospective analyzed. Results In the 66 children with traumatic cerebral infarction, 12 cases （ 18.2% ） were dead, 54 cases （81.8%） were survived, including 6 cases （9.1%） with vegetative state. The influencing factors of recovery time in 54 cases survived children with traumatic cerebral infarction were large area of cerebral infarction, infection and compound injury （ OR = 2. 903, OR = 2. 092, OR = 2. 859 ; all P 〈 0. 05 ）. Compared with survived children, the GCS score at admitted to hospital was significantly decreased, and the rates of large area of cerebral infarction, compound injury, hypotension or shock, cerebral hernia and epilepsy were significantly increased, and the usage of dehydration drug especially high dosage was significantly increased （ all P 〈 0.05 ）. Multivariate Logistic regression analysis showed that the independent risky factors of death in children with traumatic cerebral infarction were low GCS score at admitted to hospital, compound injury, hypotension or shock （ all P 〈 0. 05 ）. Conclusions The influencing factors of recovery time in children with traumatic cerebral infarction are large area of cerebral infarction, infection and compound injury. Low GCS score at admitted to hospital, compound injury, hypotension or shock are the independent risky factors of death in children with traumatic cerebral infarction.