浅论影响颅脑损伤患者预后的独立危险因素

On the independent risk factors affecting prognosis of patients with craniocerebral injury

目的:分析影响颅脑损伤患者预后的独立危险因素。方法:选择2016年1月至2018年3月期间崇州市人民医院神经外科收治的50例颅脑损伤患者作为研究对象。对这50例患者的临床资料进行回顾性研究,分析其年龄、格拉斯哥昏迷评分法(GCS)的评分、脑血肿量及脑中线移位值等指标,然后,分析影响其预后的独立危险因素。结果:在这50例患者中,与年龄≤60岁的患者相比,年龄> 60岁患者的残疾率及死亡率更高;与未合并有高钠血症的患者相比,合并有高钠血症患者的残疾率及死亡率更高;与脑血肿量≤30ml的患者相比,脑血肿量> 30ml患者的残疾率及死亡率更高,与不存在脑挫裂伤的患者相比,存在脑挫裂伤患者的残疾率及死亡率更高,与GCS的评分> 9分的患者相比,GCS的评分≤9分患者的残疾率及死亡率更高,与不存在脑血肿的患者相比,存在脑血肿患者的残疾率及死亡率更高,与脑中线移位值> 10mm的患者相比,脑中线移位值≤10 mm患者的残疾率及死亡率更高(P <0.05)。对颅脑损伤患者的年龄、脑血肿量、GCS的评分等因素进行Logistic回归分析的结果显示,脑血肿量> 30ml和GCS的评分≤9分均是影响颅脑损伤患者预后的独立危险因素(P <0.05)。结论:脑血肿量> 30ml和GCS的评分≤9分是影响颅脑损伤患者预后的独立危险因素。

objective: to analyze the independent risk factors affecting the prognosis of patients with craniocerebral injury. Methods: 50 patients with craniocerebral injury admitted to the neurosurgery department of chongzhou people’s hospital from January 2016 to March 2018 were selected as research objects. The clinical data of these 50 patients were retrospectively analyzed, including their age, Glasgow coma score(GCS) score, cerebral hematoma volume and brain-line shift value, and then independent risk factors affecting their prognosis were analyzed. Results: among the 50 patients, the disability rate and mortality rate of patients aged > 60 years were higher than those aged ≤ 60 years. Patients with hypernatremia had higher rates of disability and mortality than those without hypernatremia. Than did patients with cerebral hematoma volume 30 ml or less, the patients with cerebral hematoma volume > 30 ml of disability and mortality is higher, compared with no brain contusion patients, patients with cerebral contusion in disability and mortality is higher, compared with patients with GCS score > 9 points, GCS score nine points or less disability and mortality in patients with higher, compared with no brain hematomas patients, patients with cerebral hematoma in the disability and mortality is higher, and the midline shift value > 10 mm compared with patients, midline shift values 10 mm or less disability and mortality in patients with higher(P < 0.05). The results of Logistic regression analysis on age, amount of cerebral hematoma, GCS score and other factors of patients with craniocerebral injury showed that > 30 ml and GCS score ≤ 9 were both independent risk factors affecting the prognosis of patients with craniocerebral injury(P < 0.05). Conclusion: > 30 ml and GCS score ≤ 9 are independent risk factors for prognosis of patients with craniocerebral injury.