重型颅脑损伤合并胸腹部损伤患者预后影响因素分析

Analysis of prognostic factors in patients with severe craniocerebral injury and thoracoabdominal injury

目的 探讨影响重型颅脑损伤合并胸腹部损伤患者预后的影响因素。方法 选取98例重型颅脑损伤合并胸腹部损伤患者作为研究对象,按照患者离院时的生存状态将患者化分成死亡组(18例)和生存组(80例)。收集两组患者年龄、性别、基础病症、收缩压、血糖、白细胞计数、格拉斯哥昏迷量表(GCS)及损伤严重度(ISS)评分、受伤至治疗时间、治疗方法以及是否并发休克、癫痫、感染,进行患者预后的影响因素分析。结果 经多因素Logistic回归分析,存在基础病症、收缩压≤60 mm Hg(1 mm Hg=0.133 kPa)、GCS评分3~5分、ISS>25分、受伤至治疗时间>6 h、并发休克为影响患者预后的独立危险因素,差异均具有统计学意义(P<0.05)。结论 基础病症、收缩压、GCS和ISS评分、救治周期、并发休克等是影响患者预后的独立危险因素,临床应根据危险因素来采取针对性的治疗措施,从而改善患者预后。

Objective To discuss the prognostic factors in patients with severe craniocerebral injury and thoracoabdominal injury.Methods A total of 98 patients with severe craniocerebral injury and thoracoabdominal injury as study subjects were divided into death group(18 cases)and survival group(80 cases)according to survival state at discharge.Age,gender,underlying illness,systolic blood pressure,blood glucose,white blood cell count,Glasgow coma scale(GCS)and injury severity score(ISS),injury to treatment time,treatment method and whether it is complicated by shock,epilepsy,infection status of the two groups were collected for prognostic factors analysis.Results Through multi-factor Logistic regression analysis,underlying illness,systolic blood pressure≤60 mm Hg(1 mm Hg=0.133 kPa),GCS score 3-5 points,ISS>25 points,time from injury to treatment>6 h,complicated shock were independent risk factors for the prognosis of patients,and the difference was statistically significant(P<0.05).Conclusion Underlying illness,systolic blood pressure,GCS,ISS score,treatment cycle,and concurrent shock are independent risk factors that affect the prognosis of patients.The clinic should take targeted treatment measures based on the risk factors to improve patient prognosis.