颅脑损伤继发创伤性脑梗死的临床特点及其相关危险因素

Clinical characteristics and related risk factors of traumatic cerebral infarction after craniocerebral trauma

目的观察颅脑损伤继发创伤性脑梗死的临床特点及发生的相关危险因素。方法选取2014年1月至2015年6月在我院住院的颅脑损伤患者80例进行研究,按是否继发创伤性脑梗死(TCI)将患者分为TCI组和非TCI组,观察TCI组的临床特点,对患者的年龄、性别、GCS评分、脑疝、颅骨骨折、糖尿病、蛛网膜下腔出血、低血压等因素进行统计学分析,探究颅脑损伤继发创伤性脑梗死的相关危险因素。结果 TCI的临床特点主要是偏侧肢体运动及感觉功能障碍、视功能异常、语言功能异常、反应迟钝,TCI的预后为良好11例、轻度残疾7例、重度残疾5例、死亡3例。单因素分析结果提示TCI主要与年龄、GCS评分、脑疝、低血压、蛛网膜下隙出血、颅底骨折等因素具有相关性(P <0. 05),经由Logistic回归分析表明,低血压、脑疝属于TCI的独立高危因素。结论低血压和脑疝为颅脑损伤继发TCI的独立危险因素,合理进行干预对预防TCI的发生具有重大临床意义。

Objective The clinical characteristics and related risk factors of traumatic cerebral infarction after craniocerebral injury were discussed.Methods A total of 80 patients with brain injury treated from January 2014 to June 2015 were studied.Patients were divided into TCI group and non-TCI group according to the secondary traumatic cerebral infarction(TCI).The clinical characteristics of TCI group were observed.GCS score,cerebral hernia,skull fracture,diabetes,subarachnoid hemorrhage,hypotension and other factors were analyzed.Related risk factors of traumatic cerebral infarction after craniocerebral trauma were also studied.Results The clinical features of TCI included the movement and sensory dysfunction of the suffered side,the abnormal visual function,the abnormal language function and the slow reaction.The prognosis of TCI was good in11cases,mild disability in7cases,severe disability in5cases,and death in 3 cases.Single factor analysis showed that TCI related factors included age,GCS score,cerebral hernia,hypotension,subarachnoid space hemorrhage and skull base fracture(P<0.05).Logistic regression analysis showed that the independent risk factors of TCI line were hypotension and cerebral hernia.Conclusion Hypotension and cerebral hernia are independent risk factors for brain injury secondary to TCI and the rational clinical intervention has important clinical significance for the prevention of secondary TCI.