颅脑外伤后长期昏迷的影响因素

Influencing Factors of Long-term Coma after Craniocerebral Trauma

目的:调查颅脑外伤后长期昏迷(昏迷时间≥30 d)的影响因素,为制定干预措施提供参考。方法:选择2018年9月-2019年12月本院诊治的颅脑外伤后昏迷患者113例。收集患者社会人口学特征、临床数据及昏迷状态(昏迷时间≥30 d为昏迷组,昏迷时间<30 d为清醒组),采用单因素、多因素逻辑回归模型分析昏迷状态的影响因素。结果:113例患者中清醒组81例、昏迷组32例。收缩压异常、二便失禁、脑内血肿、肺部感染和RCTC评分高是影响长期昏迷的独立风险因素(P<0.05)。结论:入院时收缩压异常、二便失禁、脑内血肿、并发肺部感染和RCTC评分高可能预示患者发生长期昏迷,提示对上述指标加以监测对预防长期昏迷的发生和发展有重要价值。

Objective:To investigate the influencing factors of long-term coma(coma time≥30 d)after craniocerebral trauma,so as to provide reference for formulating intervention measures.Method:From September 2018 to December 2019,113 patients with coma after craniocerebral injury were selected and treated in our hospital.The social demographic characteristics,clinical data and coma status of the patients were collected(coma duration≥30 d was the coma group,and coma duration<30 d was the awake group),and the influencing factors of coma status were analyzed by using single-factor and multi-factor logistic regression models.Result:Among 113 patients,81 cases were in awake group and 32 cases were in coma group.Abnormal systolic blood pressure,urinary and fecal incontinence,intracerebral hematoma,pulmonary infection and high RCTC score were independent risk factors for long-term coma(P<0.05).Conclusion:Abnormal systolic blood pressure at admission,urinary and fecal incontinence,intracerebral hematoma,concurrent pulmonary infection,and high RCTC score may indicate long-term coma of the patient,suggesting that monitoring the above indicators is of great value in preventing the occurrence and development of long-term coma.