外伤后急性弥漫性脑肿胀的危险因素的研究

Risk factors of post-traumatic acute diffuse brain swelling

目的探讨外伤后急性弥漫性脑肿胀(PADBS)的危险因素。方法分析2015年6月至2019年12月华中科技大学协和江北医院重症医学科收治的100例脑外伤患者的相关资料,根据是否发生PADBS,将发生PADBS的患者20例分成观察组,未发生PADBS的患者80例作为对照组,通过Logistic回归分析探讨发生PADBS的影响因素。结果Logistic回归分析结果表明,误吸[优势比(OR):4.483,95%置信区间(CI):1.053~19.082,P<0.05]、低血压(OR:2.582,95%CI:2.277~76.736,P<0.05)、原发脑干损伤(OR:3.363,95%CI:4.599~181.335,P<0.05)、心跳骤停(OR:3.297,95%CI:3.657~199.738,P<0.05)、瞳孔变化(OR:3.078,95%CI:3.437~137.098,P<0.05)是影响PADBS发生的独立危险因素。结论PADBS的救治原则就是发现及时,早期干预。一旦发生误吸、低血压、原发性脑干损伤、心跳骤停、瞳孔变化等,给予早期积极救治,以降低PADBS发生率。

Objective To investigate the risk factors of post-traumatic acute diffuse brain swelling(PADBS).Methods Totally,100 patients with brain trauma admitted in Department of Critical Care Medicine,Union Jiangbei Hospital,Huazhong University of Science and Technology from June 2015 to December 2019 were retrospectively analyzed.A total of 20 cerebral trauma patients with PADBS served as observation group,and 80 patients without PADBS as control group.The influence factors of PADBS were analyzed by Logistic regression analysis.Results The Logistic regression analysis revealed that aspiration[odds ratio(OR):4.483,95%confidence interval(CI):1.053-19.082,P<0.05],hypotension(OR:2.582,95%CI:2.277-76.736,P<0.05),primary brain stem injury(OR:3.363,95%CI:4.599-181.335,P<0.05),cardiac arrest(OR:3.297,95%CI:3.657-199.738,P<0.05),pupil changes(OR:3.078,95%CI:3.437-137.098,P<0.05)were independent risk factors for PADBS.Conclusion The treatment principle of PADBS is timely detection and early intervention.Once aspiration,hypotension,primary brain stem injury,cardiac arrest,pupil changes occurred,early active treatment should be given to reduce the incidence of PADBS.