重型、特重型颅脑外伤并发外伤性脑梗死的病例对照分析  

Case-control Analysis of Posttraumatic Cerebral Infarction in Patients with Severe and Extremely Severe Head Injury

作　　者：李艾群 

机构地区：[1]天门市第一人民医院脑外科,天门431700

出　　处：《中国医药导刊》2014年第4期569-570,共2页Chinese Journal of Medicinal Guide

摘　　要：目的：探讨重型、特重型颅脑外伤并发外伤性脑梗死的临床特点和危险因素，并提出相应对策。方法：对2010年8月-2012年8月在我科室住院的260例患者资料进行回顾性病例对照分析，找出其危险因素和保护因素。结果：研究组重残率11.67%（7/60），死亡率21.67%（13/60）；对照组重残率2.50%（5/200），死亡率8.50%（17/60）。研究组重残率和死亡率高于对照组，差异有统计学意义（P〈0.05）。多因素Logistic回归分析的结果显示：年龄≥50岁（OR=4.44）、GCS评分＜5分（OR=4.26）、脱水药过量使用（OR=3.39）、合并感染（OR=3.16）、合并糖尿病史（OR=2.66）和合并低血压休克（OR=5.81）是PTC发生的危险因素。活血药使用（OR=0.23）是保护因素。结论：重型、特重型颅脑并发外伤性脑梗死会导致患者预后不良，对有并发PTC风险的患者应对密切观察，及时行影像学检查早期诊断，合理使用脱水药和活血药，降低患者并发PTC的风险。Objective： To investigate risk factors of posttraumatic cerebral infarction in patients with severe and extremely severe head injury and put forward the corresponding countermeasures. Methods：During August 2010 to August 2012,260 cases were retrospectively analyzed to find risk factors of posttraumatic cerebral infarction. Results：Disability rate of study group was 11.67%（7/60） and the mortality rate was 21.67%（13/60）;Severe disability rate of control group was 2.50%（5/200） and the mortality rate was 8.50%（17/60）.Severe disability and mortality rates of study group were significantly higher than control group（P〈0.05）. Multivariate Logistic regression analysis showed that age≥50 （OR=4.44）, GCS score〈5（OR=4.26）, dehydrated drug use （OR=3.39）, infection （OR=3.16,95%CI=1.31-7.63）, history of diabetes （OR=2.66） and hypotension （OR=5.81） were risk factors of PTC. Promoting blood drug （OR=0.23） were the protective factors. Conclusion：Heavy, severe head trauma patients with cerebral infarction can cause poor prognosis. The early imaging diagnostic reasonable dehydration drugs and blood drug can reduce the risk of patients with PTC.

关 键 词：外伤性脑梗死 颅脑外伤 危险因素 

分 类 号：R651.11[医药卫生—外科学]