重型颅脑损伤去骨瓣减压术后再发血肿的相关因素及预后分析  

Analysis of Relevant Factors of Postoperative Hematoma Recurrence after Evacuation and Prognosis of Patients with Severe Head Injury

作　　者：王筱红[1] 

机构地区：[1]湖北省天门市第一人民医院护理部,天门431700

出　　处：《中国医药导刊》2014年第2期211-212,共2页Chinese Journal of Medicinal Guide

摘　　要：目的：探讨重型颅脑颅脑损伤去骨瓣减压术后再发血肿的危险因素。方法：对2010年8月-2012年8月在我科室住院的192例患者资料进行回顾性分析,探讨分析术后再发血肿的危险因素。结果：研究组良好10例（15.15%）,轻/中残21例（31.82%）,重残20例（30.30%）,植物生存/死亡15例（22.73%）。对照组良好58例（46.03%）,轻/中残27例（21.43%）,重残19例（15.07%）,植物生存/死亡22例（17.46%）。研究组治疗效果明显差于对照组,差异有统计学意义（P〈0.05）。昏迷（OR=3.56,95% CI=1.66-7.65）、Babinsiki征阳性（OR=2.86,95%CI=2.07-9.16）、空腹血糖≥110mg/dL（OR=2.27,95%CI=1.24-4.17）和初发血肿量≥50ml （OR=1.92,95%CI=1.17-3.13）是再发血肿发生的危险因素。结论：昏迷、Babinsiki征阳性、空腹血糖和初发血肿量是重型颅脑去骨瓣减压术后再发出血的独立危险因素。Objective：To investigate risk factors of posttraumatic cerebral infarction in patients with severe head injury and put forward the corresponding countermeasures.Methods：During August 2010 to August 2012,192 cases were retrospectively analyzed to find risk factors of postoperative hematoma recurrence.Results：Study group：10 cases （15.15%） were good prognosis,21 cases （31.82%） were light / moderate disability,20 cases （30.30%） were severe disability and 15 cases （22.73%） were plants survival / death.Control group：58 cases （46.03%） were good prognosis,27 cases （21.43%） were light/moderate disability,19 cases （15.07%） were severe disability and 22 cases （17.46%） were plants survival/death.Severe disability and mortality rates of study group were significantly higher than control group（P〈0.05）.Multivariate Logistic regression analysis showed that coma （OR=3.56,95%CI=1.66-7.65）,positive Babinsiki sign （OR=2.86,95%CI=2.07-9.16）,fasting blood glucose≥110mg/dL（OR=2.27,95%CI=1.24-4.17） and onset the hematoma volume≥50ml （OR=1.92,95%CI=1.17-3.13） were risk factors for recurrent hematoma.Conclusion：Coma,positive Babinsiki sign,blood glucose and the initial issuance of the hematoma volume are independent risk factors for postoperative hematoma recurrence after evacuation of patients with severe head injury.

关 键 词：脑出血 颅脑外伤 危险因素 去骨瓣减压术 

分 类 号：R651.15[医药卫生—外科学]