重型颅脑损伤合并胸腹部损伤患者预后影响因素

Prognostic factors of patients with severe craniocerebral injury combined with thoracic and abdominal injuries

目的 :探讨影响重型颅脑损伤合并胸腹部损伤患者预后的因素。方法 :回顾性分析2010年6月～2016年10月在我院接受治疗的98例重型颅脑损伤合并胸腹部损伤患者的临床资料,对可能影响患者预后的危险因素进行单因素分析和多因素Logistic回归分析。结果 :单因素分析发现,年龄、基础疾病、收缩压、血糖、白细胞计数、GCS评分、ISS评分、受伤至治疗时间、治疗方式、是否并发休克是影响重型颅脑损伤合并胸腹部损伤患者预后的危险因素。多因素Logistic回归分析发现,有基础疾病、收缩压≤60mmHg、GCS评分3～5分、ISS评分>25分、受伤至治疗时间>6h、合并休克是影响重型颅脑损伤合并胸腹部损伤患者预后的独立危险因素。结论 :存在基础疾病、收缩压≤60mmHg、GCS评分≤8分、ISS评分>25分、受伤至治疗时间>6h及合并休克是造成重型颅脑损伤合并胸腹部损伤患者死亡的独立危险因素,临床应根据危险因素来采取针对性的治疗措施,从而改善患者预后。

Objective To explore the prognostic factors of patients with severe craniocerebral injury combined with thoracic and abdominal injuries.Methods The clinical data of 98 patients with severe craniocerebral injury combined with thoracic and abdominal injuries who were treated in our hospital from June 2010 to October 2016 were retrospectively analyzed.Univariate analysis and multivariate logistic regression were used to analyze the risk factors analysis.Results Univariate analysis found that age,underlying disease,systolic blood pressure,blood glucose,white blood cell count,GCS score,ISS score,injury to treatment time,treatment way,whether concurrent shock were the risk factors of severe craniocerebral injury patients with thoracic and abdominal injury.Multivariate logistic regression analysis showed that underlying diseases,systolic blood pressure≤60 mm Hg,GCS score 3~5 points,ISS score>25 points,injury to treatment time>6 h,combined shock were the independent risk factors of severe craniocerebral injury patients with thoracic and abdominal injury.Conclusion Underlying diseases,systolic blood pressure≤60 mm Hg,GCS score≤8 points,ISS score>25 points,injury to treatment time>6 h and combined shock are independent risk factors of severe craniocerebral injury patients with thoracic and abdominal injury,the clinic should take targeted treatment measures based on risk factors,thereby improving the prognosis of patients.