脑外伤所致精神障碍的危险因素分析  

Analysis of the Risk of Mental Disorders Due to Brain Injury of Factors

作　　者：程民[1] 黄德玖 许晓军[1] 黄文忠[1] 崔良良 费舟[2] 

机构地区：[1]内江市资中县人民医院外三科,四川内江641200 [2]第四军医大学西京医院神经外科,陕西西安710032

出　　处：《现代生物医学进展》2013年第31期6136-6139,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金青年科学基金项目(81101710/H1611)

摘　　要：目的:探究脑外伤所致精神障碍的的危险因素,以探究各类因素与脑外伤患者预后的关联,为今后的临床治疗及干预措施提供理论依据。方法:对我院2009年6月-2012年9月收治的217例脑外伤患者进行回顾分析,按照其是否出现精神障碍分为精神障碍组及非精神障碍组,对比其临床资料,将存在统计学意义的指标纳入Logistic多因素回归分析,探讨脑外伤所致精神障碍的的危险因素。结果:217例脑外伤患者共出现162例精神障碍,精神障碍发病率74.7%;两组患者一般资料对比可见,颅内血肿、脑干损伤、脑叶损伤范围、GCS评分及EPQ评分存在统计学意义(p<0.05);多因素回归分析发现,GCS评分≤8分及EPQ评分≥30分存在统计学差异(p<0.05),是影响脑外伤所致精神障碍的独立危险因素。结论:GCS评分≤8分及EPQ评分≥30分存在统计学差异(p<0.05),是影响脑外伤所致精神障碍的独立危险因素,应在患者接受常规脑外伤治疗后进行环境护理、日常生活护理及心理护理,改善其不稳定情绪,并对其意识状态进行密切监测,必要时可预防性使用抗精神病药物,以降低患者精神障碍患病率,改善其生活质量。Objective： To explore the risk factors of mental disorders caused by brain injury, to explore the various factors associ- ated with the prognosis of patients with brain injury, and to provide theoretical basis for clinical treatment and intervention measures in the future. Methods： A retrospective analysis was performed about the clinical data of 217 patients with the traumatic brain who were treated in our hospital from June 2009 to September 2012. According to the mental disorder, the selected patients were divided into the mental disorder group and the control group. Then the risk factors were analyzed by logistic regression.. Results： In 217 cases of cerebral trauma patients, there were 162 cases of mental disorder, mental disorder in- cidence rate was 74.7%; the general data of the two groups were compared in terms of the visible, intracranial hematoma, brain stem in-jury, the range of brain injury, GCS score and EPQ score, which had statistical significance （P 〈 0.05）; multiple regression analysis showed that, GCS score 〈 8 and EPQ score -〉 30, had significant differences （P 〈 0.05）, and is an independent risk factor of mental disorder caused by traumatic brain injury. Conclusions： GCS score -〈 8 and EPQ 〉 30, had statistically significant difference （P 〈 0.05）, is an independent risk factor of influence of mental disorders caused by cerebral trauma, environmental care, treatment of traumatic brain injury patients after routine in daily life care and psychological care, improve their emotional instability, and closely monitor the state of consciousness, if necessary, the preventive use of antipsychotic drugs, can reduce the prevalence of mental disorder patients, and can improve the quality of life.

关 键 词：脑外伤 精神障碍 危险因素 LOGISTIC回归分析 干预 

分 类 号：R651[医药卫生—外科学] R749.1[医药卫生—临床医学]