急性创伤性颞叶血肿92例及预后危险因素分析

Analysis of Prognostic Factors in Temporal Hematoma of Acute Traumatic Brain Injury

目的探讨急性创伤性大脑颞叶血肿的不良预后危险因素分析。方法回顾性分析笔者所在科室92例创伤后单纯颞叶血肿患者,以住院临床死亡为终点事件,统计临床相关指标进行分析。结果 92例中住院期间临床死亡10例,占10.9%。年龄均>45岁。单因素分析显示创伤后单纯颞叶血肿病死率与患者年龄、血肿量、入院GCS评分、血肿侧瞳孔对光反应消失及是否手术相关。多因素分析显示患者年龄、血肿量及手术治疗具有相关显著性。结论创伤后颞叶血肿的临床不良预后与年龄、血肿量和手术治疗呈显著相关。在临床诊治过程中,入院格拉斯哥昏迷指数(Glasgow coma Score,GCS)评分可作为重要参考,但是应随时评估,及时有效地把握手术指征对于患者的生存有重要作用。

To evaluate the relative factors that affect the prognosis of temporal intraparenchymal hematoma after traumat-ic brain injury. Methods We retrospectively searched and reviewed the previous 92 clinical cases of temporal intraparenchymal hemato- ma after traumatic brain injury in our department and assessed the cases based on the mortality during in - hospital stay. Statistical analy- sis was performed using SPSS on those potential clinical factors which may affect the prognosis. Results Of 92 cases, there were 10 pa- tients died, with a mortality rate of 10.8%. All of mortality cases are older than 45 years old. Univariate analysis showed the age, volume of hematoma, GCS at admission,reactivity of pupil at hematoma side and surgical treatment are significantly related to the prognosis. Mult- ivariate analysis showed only age, volume of bematoma and surgical operation are significant factors. Conclusion The prognosis of tem- poral intraparenchymal hematoma was significantly related to the patient＇s age, volume of hematoma and surgical treatment. GCS at admis- sion can be considered as one of important factors but should be carefully monitored.