重型颅脑损伤患者术后认知功能障碍发生情况及影响因素分析

Analysis on the occurrence of postoperative cognitive dysfunction and its influencing factors with severe craniocerebral injury

目的研究分析重型颅脑损伤患者术后认知功能障碍发生情况及影响因素。方法选取海军陆战队医院的150例重型颅脑损伤患者为研究对象,将其术后认知障碍发生率进行统计,比较不同年龄、性别、文化程度、损伤部位、入院时格拉斯哥昏迷(Glasgow Coma Scale,GCS)评分、损伤部位数量、致伤原因、吸烟史、饮酒史、并发症发生情况及基础疾病情况者的术后认知障碍发生率,采用多因素Logistic回归分析重型颅脑损伤患者术后认知功能障碍发生的影响因素。结果150例重型颅脑损伤患者发生术后认知障碍111例,发生率为74.00%,不同性别、致伤原因、吸烟史及饮酒史情况者的术后认知障碍发生率比较差异无统计学意义(P>0.05),>50岁、小学、额叶、入院时GCS评分3~5分、损伤部位数量≥2个、并发症发生及基础疾病者的术后认知障碍发生率显著高于其他患者(P<0.05),多因素Logistic回归分析显示,>50岁、小学、额叶、入院时GCS评分3~5分、损伤部位数量≥2个、并发症发生及基础疾病是重型颅脑损伤患者术后认知功能障碍发生的影响因素(P<0.05)。结论重型颅脑损伤患者术后认知功能障碍发生率较高,且其影响因素种类较多,可作为重型颅脑损伤患者术后认知功能障碍干预措施的主要参考依据。

Objective To study and analyze the occurrence of postoperative cognitive dysfunction(POCD)and its influencing factors in patients with severe craniocerebral injury(SCCI).Methods A total of 150 patients with SCCI treated in Marine Corps Hospital were selected as the research subjects,and POCD rate of all the patients was analyzed.POCD rates of patients with different ages,genders,education levels,injury sites,Glasgow Coma Scale(GCS)score at admission,number of injury sites,causes of injury,smoking history,drinking history,complications and underlying diseases were compared,and the influencing factors of POCD of patients with SCCI were analyzed with multivariate Logistic regression analysis.Results Among 150 patients with SCI,111 patients developed POCD,with an incidence rate of 74.00%,there was no significant difference in the rate of POCD in patients with different genders,causes of injury,smoking history and drinking history(P>0.05).POCD rates of patients aged>50 years years,primary school education,injury site of frontal lobe,GCS score of 3 to 5 points at admission,number of injury sites≥2,complications and underlying diseases were significantly higher than those of other patients(P<0.05).Multivariate Logistic regression analysis showed>50 years of age,primary school education,injury site of frontal lobe,GCS score of 3 to 5 points at admission,number of injury sites≥2,complications and underlying diseases were the influencing factors of POCD of patients with SCCI(P<0.05).Conclusion Patients with SCCI have a high rate of POCD,which has various influencing factors.Therefore,they can provide major reference for the intervention of POCD of patients with SCCI.