颅脑损伤后颅内进展性出血性损伤的危险因素及预后研究

Clinical research for risk factors and prognosis of progressive hemorrhagic injury after traumatic brain injury

目的:探讨颅脑损伤后颅内进展性出血损伤的危险因素及预后情况。方法:选取创伤性颅脑损伤患者116例,根据是否发生颅内进展性出血损伤分为进展性出血性损伤组(n=51)和非进展性出血损伤组(n=65),对相关危险因素进行单因素和多因素Logistic回归分析,分析颅脑损伤后颅内进展性出血性损伤的危险因素及预后情况。结果:单因素分析显示:入院GCS评分、第一次CT时间、第二次CT血肿量、PT、INR、D-D、FPD及PLT水平是颅脑损伤后颅内进展性出血性损伤的危险因素(P<0.05);多因素Logistic回归分析结果显示:入院GCS评分、第一次CT时间、D-D、PLT、FDP及INR水平确定为颅脑损伤后颅内进展性出血性损伤的独立危险因素(P<0.05);进展性出血损伤组恢复良好率,低于非进展性出血损伤组(P<0.05);进展性出血损伤组残疾率、植物生存率及病死率,高于非进展性出血损伤组(P<0.05)。结论:颅脑损伤后颅内进展性出血性损伤的危险因素相对较多,应该根据危险因素及时采取有效的措施进行干预、预防,改善患者治疗预后。

Objective：To observe the risk factors and prognosis of progressive hemorrhagic injury after traumatic brain injury.Methods：Collect clinical data from 116 cases of traumatic brain injury.They were divided into progressive hemorrhagic injury group （n=51） and non progressive hemorrhagic injury group （n=65） according to whether progressive hemorrhagic injury occurred.The risk factors were analysed by the univariate and multivariate Logistic regression to value the risk factors and prognosis of progressive hemorrhagic injury after traumatic brain injury.Results：Univariate analysis showed that admission score of GCS、the first CT examination time,the second CT hematoma volume、PT、INR、D-D、FPD and PLT level were the influencing factors of progressive hemorrhagic injury after traumatic brain injury（P〈0.05）;Admission score of GCS 、the first CT examination time,D-D、PLT、FPD and INR level have been identified as the independent risk factors of progressive hemorrhagic injury after traumatic brain injury（P〈0.05）;The rate of recovery in progressive hemorrhagic injury was lower than that of non-progressive hemorrhagic injury group （P〈0.05）;The rate of disability,survival rate and mortality of patients in progressive hemorrhagic injury was higher than that of non-progressive hemorrhagic injury group （P〈0.05）.Conclusion：The risk factors of intracranial progressive hemorrhagic injury after traumatic brain injury are relatively more,it should take timely and effective measures to prevent based on the risk factors,improve patient prognosis.