重型脑外伤性大面积脑梗死的诱发因素研究

Inducing factors of massive cerebral infarction after severe traumatic brain injury

目的研究重型脑外伤性大面积脑梗死的诱发因素。方法选取我院2017年1月至2021年1月收治的重型脑外伤性大面积脑梗死患者98例作为观察组、重型脑损伤不合并脑梗死患者129例作为对照组,对两组患者进行单因素分析,对其中有统计意义的因素再行多因素分析,确定重型脑外伤性大面积脑梗死的诱发因素。结果通过单因素和多因素Logistic分析结果显示:年龄(P=0.000)、高血压病史(P=0.001)、合并脑疝(P=0.000)、凝血异常(P=0.004)、合并外伤性蛛网膜下腔出血(P=0.019)、外伤后应用止血药(P=0.004)是诱发重型脑外伤的独立危险因素。结论重型脑外伤性大面积脑梗死的发生可能是以上1种或几种因素共同作用的结果,因此,在救治此类患者时,需要引起高度重视,要做到诊断快速准确、治疗合理,从而改善患者的生存率和生存质量。

Objective To explore the inducing factors of massive cerebral infarction after severe traumatic brain injury(TBI).Methods A total of 98 patients with large area cerebral infarction after severe TBI and 129 patients with severe TBI without cerebral infarction admitted to our hospital from January 2017 to January 2021 were selected as observation group and control group.Univariate analysis was performed on the two groups of patients,and multivariate analysis was performed to determine the inducing factors of large area cerebral infarction after severe TBI.Results The results of univariate and multivariate Logistic analysis showed that age(P=0.000),history of hypertension(P=0.001),cerebral hernia(P=0.000),abnormal coagulation(P=0.004),traumatic subarachnoid hemorrhage(P=0.019),and posttraumatic hemostatic use(P=0.004)were independent risk factors for massive cerebral infarction after severe TBI.Conclusion The occurrence of massive cerebral infarction after severe TBI may be the result of one or several factors of the above mentioned.Therefore,in the treatment of such patients,great attention should be paid to the rapid and accurate diagnosis and reasonable treatment,so as to improve the survival rate and quality of life of the patients.