颅脑损伤合并多发伤预后的影响因素分析

Analysis of Factors Influencing Prognosis of Craniocerebral Injury Complicated with Multiple Injuries

目的:分析颅脑损伤合并多发伤预后的影响因素及急诊救治效果。方法:选取2020年1月—2022年12月合浦县人民医院收治的66例颅脑损伤合并多发伤患者为观察对象,根据出院时状态将患者分为生存组(n=56)和死亡组(n=10)。所有患者根据具体情况给予相应冶疗,分析患者预后的影响因素。结果:单因素分析结果显示,两组患者存在基础性疾病、收缩压≤139 mmHg、格拉斯哥昏迷评分(GCS评分)、创伤严重程度量表(ISS)评分、伤后时间、血小板计数、餐后2 h血糖、休克、胸腹部损伤和急性呼吸窘迫综合征(ARDS)比较,差异有统计学意义(P<0.05)。多因素回归分析显示,收缩压≤139 mmHg、存在基础性疾病、GCS评分≤8分、ISS评分≥25分、伤后时间>5 h、伴胸腹部损伤、伴休克及ARDS属于颅脑损伤合并多发伤患者的预后影响因素(P<0.05)。结论:对于颅脑损伤合并多发伤患者,需要确认其预后的影响因素,据此建立快速救治通道,对患者临床特点进行评估,为患者提供及时有效的救治措施,降低并发症发生率及死亡率,改善其预后。

Objective:To analyze the prognostic factors and emergency treatment effect of craniocerebral injury complicated with multiple injuries.Methods:Sixty-six patients with craniocerebral injury complicated with multiple injuries admitted to Hepu County People's Hospital from January 2020 to December 2022 were selected as the observation objects.According to their status at discharge,the patients were divided into survival group(n=56)and death group(n=10).All patients were given corresponding treatment according to specific conditions,and the influencing factors of prognosis were analyzed.Results:The results of univariate analysis showed that there were underlying diseases,systolic blood pressure≤139 mmHg,glasgow coma score(GCS score),trauma severity scale(ISS)score,post-injury time,platelet count,blood glucose 2 h postprandial,shock,chest and abdominal injury and acute respiratory distress syndrome(ARDS)in the two groups.The difference was statistically significant(P<0.05).Multivariate regression analysis showed that systolic blood pressure≤139 mmHg,presence of underlying diseases,GCS score≤8,ISS score≥25,time>5 h after injury,chest and abdominal injury,shock and ARDS were prognostic factors in patients with craniocerebral injury complicated with multiple injuries(P<0.05).Conclusion:For patients with craniocerebral injury complicated with multiple injuries,it is necessary to identify the factors affecting the prognosis,establish a rapid treatment channel,evaluate the clinical characteristics of patients,provide timely and effective treatment measures for patients,reduce the incidence of complications and mortality,and improve the prognosis.