颅脑创伤患者颅底骨折与颅内出血的相关性分析

目的分析颅脑创伤患者颅底骨折与颅内出血的相关性.方法回顾性分析2012年1月至2017年12月头部外伤患者8,137例.根据GCS评分,将颅脑损伤分为轻型、中型和重型.根据CT检查分析颅底骨折和颅内损伤情况.对两者之间的相关性采用Logistic分析.结果共纳入患者8,137例,在所有颅底骨折患者中,前窝处颅底骨折占68.90%,多伴有轻度颅脑创伤(62.52%).颅脑创伤的严重程度和颅底骨折的位置与CT扫描上是否存在颅脑外伤有关,这些因素可以预测是否存在颅脑外伤.硬膜外出血多为单一外伤性病变,而脑挫裂伤多为多发外伤性病变.同时伴有创伤性脑损伤和颅底骨折的患者,前窝颅底骨折患者大多有硬膜外出血;而大多数中窝颅底骨折患者伴有脑挫伤,大多数颅底骨折患者不需要手术.结论颅底骨折与外伤性颅内出血病变密切相关.颅前窝骨折患者最易出现硬膜外出血,而颅中窝骨折患者最易出现脑挫伤.

Objective To analyze the correlation between skull base fracture and intracranial hemorrhage in patients with traumatic brain injury.Methods 8,137 patients with traumatic brain injury admitted to our hospital from January 1,2012 to December 31,2020 were retrospectively analyzed.According to the GCS score,the traumatic brain injury was classified as mild,moderate,and severe.The skull base fracture and intracranial hemorrhage were analyzed according to CT examination.Logistic analysis was used to analyze the correlation between the two.Results A total of 8,137 patients were included in this study.Among all skull base fracture cases,skull base fracture at the anterior fossa accounted for 68.90%,most of which were accompanied by mild traumatic brain injury(62.52%).The severity of the trauma and the location of the skull base fracture correlated with the presence of traumatic brain injury on the CT scan,and these factors can predict the presence of traumatic brain injury.The patients with epidural hemorrhage were mostly a single traumatic lesion,while the patients with cerebral contusion were mostly multiple traumatic lesions.In patients with traumatic brain injury and skull base fracture,most of them with skull base fracture in the anterior fossa had epidural hemorrhage.However,most of the patients with middle fossa skull base fracture were accompanied by cerebral contusion.Most patients with skull base fractures did not require surgery.Conclusion Skull base fracture is closely related to traumatic intracranial hemorrhage.Patients with anterior cranial fossa fracture are most likely to have epidural hemorrhage,while patients with middle cranial fossa fracture are most likely to have cerebral contusion.