Objective： To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods ： Retrospective study ...Objective： To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods ： Retrospective study was made on 139 patients with severe traumatic brain injuries in our hospital. The patients were divided into two groups： hydrocephalus group and non-hydrocephalus group. Single factor analysis and multiple factor analysis were used to determine the related factors and hydrocephalus. Multiple factor analysis was conducted with logistic regression. Results： Posttraumatic hydrocephalus was found in 19.42% of patients. Age （ OR=1.050, 95% CI： 1.012-1. 090 ）, decompressive craniectomy （ OR =4.312, 95 %CI ： 1. 127-16.503 ）, subarachnoid hemorrhage （ OR = 43.421, 95 % CI ： 7. 835-240. 652 ） and continuous lumbar drainage of cerebrospinal fluid （ OR =0.045, 95%CI： 0. 011-0. 175） were screened out from nine factors as the influencing factors for posttraumatic hydrocephalus. Conclusions ： Risk factors for PTH are as follows： age, deeompressive eranieetomy and subaraehnoid hemorrhage （SAH）. Continuous lumbar drainage of eerebrospinal fluid can greatly reduce posttraumatic hydrocephalus.展开更多
Objective： To investigate the changes and effects of arginine vasopressin （AVP） in patients with acute traumatic subarachnoid hemorrhage （tSAH）. Methods： The plasma and cerebrospinal fluid （CSF） level of AVP,...Objective： To investigate the changes and effects of arginine vasopressin （AVP） in patients with acute traumatic subarachnoid hemorrhage （tSAH）. Methods： The plasma and cerebrospinal fluid （CSF） level of AVP, and intracranial pressure （ICP） were measured in a total of 21 patients within 24 hours after tSAH. The neurological status of the patients was evaluated by Glasgow Coma Scale （GCS）. Correlation between AVP and ICP, GCS was analyzed respectively. Meanwhile, 18 healthy volunteers were recruited as control group. Results： Compared with control group, the levels （pg/ml） of AVP in plasma and CSF （x±s） in tSAH group were significantly increased within 24 hours （38.72±24.71 vs 4.54±1.38 and 34.61±21.43 vs 4.13± 1.26, P〈0.01）, and was remarkably higher in GCS ≤8 group than GCS〉8 group （50.96±36.81 vs 25.26±12.87 and 44.68±31.72 vs 23.53±10.94, P〈0.05）. The CSF AVP level was correlated with ICP （r= 0.46, P〈0.05）, but no statistically significant correlation was found between plasma AVP, CSF AVP and initial GCS （r= -0.29, P〉0.05 and r= -0.32, P〉0.05, respectively）. The ICP （ram Hg） in tSAH patients was elevated and higher in GCS ≤ 8 group than in GCS〉8 group （25.9±9.7 vs 17.6±5.2, P〈0.05）. Conclusion： Our research suggests that AVP is correlated with the severity oftSAH, and may be involved in the pathophysiological process of brain damage in the early stage after tSAH. It seems that compared with the plasma AVP concentration, CSF AVP is more related to the severity oftSAH.展开更多
文摘Objective： To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods ： Retrospective study was made on 139 patients with severe traumatic brain injuries in our hospital. The patients were divided into two groups： hydrocephalus group and non-hydrocephalus group. Single factor analysis and multiple factor analysis were used to determine the related factors and hydrocephalus. Multiple factor analysis was conducted with logistic regression. Results： Posttraumatic hydrocephalus was found in 19.42% of patients. Age （ OR=1.050, 95% CI： 1.012-1. 090 ）, decompressive craniectomy （ OR =4.312, 95 %CI ： 1. 127-16.503 ）, subarachnoid hemorrhage （ OR = 43.421, 95 % CI ： 7. 835-240. 652 ） and continuous lumbar drainage of cerebrospinal fluid （ OR =0.045, 95%CI： 0. 011-0. 175） were screened out from nine factors as the influencing factors for posttraumatic hydrocephalus. Conclusions ： Risk factors for PTH are as follows： age, deeompressive eranieetomy and subaraehnoid hemorrhage （SAH）. Continuous lumbar drainage of eerebrospinal fluid can greatly reduce posttraumatic hydrocephalus.
基金This study was supported by grants from Science and Technology Department of Zhejiang Province, China （No. 2004C33048） and Zhejiang Natural Science Foundation, China （Y205096）.
文摘Objective： To investigate the changes and effects of arginine vasopressin （AVP） in patients with acute traumatic subarachnoid hemorrhage （tSAH）. Methods： The plasma and cerebrospinal fluid （CSF） level of AVP, and intracranial pressure （ICP） were measured in a total of 21 patients within 24 hours after tSAH. The neurological status of the patients was evaluated by Glasgow Coma Scale （GCS）. Correlation between AVP and ICP, GCS was analyzed respectively. Meanwhile, 18 healthy volunteers were recruited as control group. Results： Compared with control group, the levels （pg/ml） of AVP in plasma and CSF （x±s） in tSAH group were significantly increased within 24 hours （38.72±24.71 vs 4.54±1.38 and 34.61±21.43 vs 4.13± 1.26, P〈0.01）, and was remarkably higher in GCS ≤8 group than GCS〉8 group （50.96±36.81 vs 25.26±12.87 and 44.68±31.72 vs 23.53±10.94, P〈0.05）. The CSF AVP level was correlated with ICP （r= 0.46, P〈0.05）, but no statistically significant correlation was found between plasma AVP, CSF AVP and initial GCS （r= -0.29, P〉0.05 and r= -0.32, P〉0.05, respectively）. The ICP （ram Hg） in tSAH patients was elevated and higher in GCS ≤ 8 group than in GCS〉8 group （25.9±9.7 vs 17.6±5.2, P〈0.05）. Conclusion： Our research suggests that AVP is correlated with the severity oftSAH, and may be involved in the pathophysiological process of brain damage in the early stage after tSAH. It seems that compared with the plasma AVP concentration, CSF AVP is more related to the severity oftSAH.
