脑挫裂伤出血进展的危险因素分析

Multivariable regression analysis of factors related to cerebral hemorrhagic progression in patients with cerebral contusion

目的探讨影响脑挫裂伤出血进展(HPC)的危险因素。方法回顾性分析2015年12月至2019年3月收治的216例脑挫裂伤的临床资料。采用多因素logistic回归分析检验HPC的危险因素。结果 216例脑挫裂伤中,84例发生HPC,发生率为38.89%。多因素logistic回归分析结果显示,长期吸烟、入院血清离子钙水平<1.12 mmol/L、合并蛛网膜下腔出血、初始血肿体积>4.0 ml为HPC的独立危险因素(P<0.05)。结论对于脑挫裂伤病人,如果存在长期吸烟史、血清离子钙<1.12 mmol/L、蛛网膜下腔出血以及初始血肿体积>4.0 ml,应注意采取针对性措施防治HPC。

Objective To investigate the factors related to the hemorrhagic progression of contusion(HPC) in the contusion patients with closed craniocerebral injury. Methods The clinical data of 216 cerebral contusion patients with closed craniocerebral injury, who were treated in our hospital from December, 2015 to March, 2019, were analyzed retrospectively. Of these 216 patients, 84(38.9%) suffered from HPC and 132 not. The factors related to the HPC were statistically analyzed by univariate and multivariate logistic regression analyses. Results The univariate analysis showed that the factors related to HPC included the patient` age, long-term smoking history, systolic blood pressure and mean arterial pressure at admission to hospital, serum level of ionized calcium, associated traumatic subarachnoid hemorrhage and traumatic subdural hematoma and initial hematoma volume(P<0.05).The multivariate logistic regression analysis showed that the risk factors related to HPC included long-term smoking history, serum level of ionized calcium <1.12 mmol/L,associated traumatic subarachnoid hemorrhage and initial hematoma volume>4.0 ml(P<0.05). Conclusion The present results suggest that there is the high risk of HPC in the contusion patients with closed craniocerebral injury who have long-term smoking history, serum level of ionized calcium<1.12 mmol/L, associated traumatic subarachnoid hemorrhage and initial hematoma volume>4.0 ml.