重度颅脑损伤继发脑梗死危险因素分析  

Risk Factors Analysis of Traumatic Cerebral Infarction

作　　者：张牧城[1] 汪健蕾[1] 汪正光[1] 程金霞[1] 郑绍鹏[1] 姚建华[1] 方向群[1] 

机构地区：[1]黄山市人民医院重症医学科,245000

出　　处：《中国临床实用医学》2009年第6期7-9,共3页China Clinical Practical Medicine

摘　　要：目的探讨重度颅脑损伤继发外伤性脑梗死（traumatic cerebral infarction，TCI）的危险因素。方法对126例重度颅脑损伤及合并伤患者就发生TCI进行单因素和多因素Logistic回归分析。结果继发TCI47例，脑梗死组与非梗死组在低血压、脑挫裂伤、蛛网膜下腔出血、脑疝、低血压时间、脑疝时间、糖尿病（或血糖≥11．1mol／L持续24h以上）、伤后或术后机械通气〈48h比较差异均有显著性（P〈0．05），以上8因素均是发生TCI的重要危险因素；Logistic回归分析显示脑挫裂伤、伤后或术后机械通气〈48h、低血压时间、脑疝时间是发生TCI的独立危险因素。结论脑挫裂伤、伤后或术后机械通气〈48h、低血压时间、脑疝时间、低血压、蛛网膜下腔出血、脑疝、糖尿病（或血糖≥11．1mol／L持续24h）是重度颅脑损伤继发TCI的危险因素，其中脑挫裂伤、伤后或术后机械通气〈48h、低血压时间、脑疝时间是独立危险因素。Objective To find out risk factors of traumatic cerebral infarction（TCI）. Methods 126 cases in severe craniocerebral trauma were analyzed, risk factors of TCI were screened by single factor and Logis- tic regression analysis. Results TCI was found in 47 patients. There was significant difference on low blood pressure, contusion and laceration of brain, subarachnoid hemorrhage, brain herniation, duration of low blood pressure, duration of brain herniation, DM （ or duration of blood glucose more thanl 1.1 mmol/L≥ 24 h）, duration of mechanical ventilation after trauma or operation 〈 48 h between TCI group and non-TCI group （ P 〈 0. 05 ）, Logistic regression analysis of them indicated that contusion and laceration of brain, duration of mechani- cal ventilation after trauma or operation 〈 48 h, duration of low blood pressure, duration of brain hernia were in- dependent risk factors. Conclusion The contusion and laceration of brain, duration of mechanical ventilation after trauma or operation 〈 48 h, low blood pressure and its duration, brain herniation and its duration, subaraeh- noid hemorrhage, DM （ or duration of blood glucose more thanl 1.1 mmol/L I〉24 h）were the risk factors of TCI, and the contusion and laceration of brain, duration of mechanical ventilation after trauma or operation 〈 48 h, du- ration of low blood pressure, duration of brain hernia were independent risk factors.

关 键 词：重度颅脑损伤 外伤性脑梗死 危险因素 

分 类 号：R651.15[医药卫生—外科学]