非火器开放性颅脑损伤临床特征分析及死亡相关因素探讨

Investigation of clinical characteristics and death-related factors of non-firarms open head injury

目的分析非火器开放性颅脑损伤(TBI)患者的临床特征及死亡相关因素。方法对空军军医大学第一附属医院神经外科监护室自2011年1月至2019年12月收治的146例非火器开放性TBI患者的临床资料进行回顾性分析,按疾病转归将患者分为死亡组(20例)和非死亡组(126例)。将2组患者入住神经外科监护室24 h内的各项临床资料进行比较,探寻影响患者死亡的相关因素。结果单因素分析显示,致伤因素、损伤程度、是否发生脑疝、是否凝血功能异常、平均动脉压是否<90 mmHg(1 mmHg=0.133 kPa)及入院GCS评分与非火器开放性TBI患者的死亡有关;二元Logistic回归分析显示,损伤严重程度、是否脑疝及平均动脉压是否<90 mmHg是非火器开放性TBI患者死亡的独立影响因素。结论非火器开放性TBI有其独特的临床特点,其死亡与TBI程度、是否发生脑疝及平均动脉压是否<90 mmHg相关。

Objective To investigate the clinical characteristics and death-related factors of patients with non-firearms open head injury.Methods The clinical data of 146 patients with nonfirearms open head injury admitted to the Neurosurgery ICU of the First Affiliated Hospital,Air Force Military Medical University from January 2011 to December 2019 were retrospectively analyzed.According to the prognosis of disease,the patients were divided into death group(20 cases)and non-death group(126 cases).The clinical data of the two groups were compared within 24 h in the Neurosurgical ICU to explore the relevant factors affecting the death of patients.Results Univariate analysis showed that injury factors,degree of injury,cerebral hernia,coagulation dysfunction,mean arterial pressure<90 mmHg(1 mmHg=0.133 kPa)and admission GCS score were related to the death of patients with non-firearms open head injury;Binary Logistic regression analysis showed that the severity of injury,cerebral hernia and mean arterial pressure<90 mmHg were the independent factors influencing the death of patients with non-firearms open head injury.Conclusion Non-firearms open head injury has its unique clinical characteristics,and its mortality was related to the degree of head injury,cerebral hernia and mean arterial pressure less than 90 mmHg.