颅脑损伤术后发生脑梗死的相关高危因素探讨  

Study on risk factors related to cerebral infarction after traumatic brain injury

作　　者：魏小川[1] 

机构地区：[1]湖北省黄冈市中心医院神经外科,湖北黄冈438000

出　　处：《临床和实验医学杂志》2015年第6期466-469,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨颅脑损伤术后患者发生脑梗死的相关高危因素。方法选取2010年6月至2014年6月收治的颅脑损伤术后的800例患者为研究对象,对患者的年龄、性别、格拉斯哥昏迷评分(GCS)、脑血管痉挛、是否并发脑疝、脑挫裂伤、糖尿病、入院时血压等临床资料进行回顾性分析。采用描述性统计和Logistic回归分析颅脑损伤术后患者发生脑梗死的影响因素。结果 800例临床资料完整的颅脑损伤术后发生脑梗死的患者有45例,发生率为5.63%,死亡2例,病死率为4.44%,年龄、GCS评分、脑血管痉挛、并发脑疝、脑挫裂伤、糖尿病及低血压这7个因素经统计学检验差异有统计学意义(P<0.05);经多因素Logistic回归分析发现颅脑损伤术后患者发生脑梗死与低龄、低GCS、低收缩压、脑血管痉挛、并发脑疝、脑损伤类型中的脑挫裂伤、糖尿病及低血压等因素关系密切。结论低龄、低GCS、低收缩压、脑血管痉挛、并发脑疝、脑损伤类型中的脑挫裂伤、糖尿病及低血压等因素可能是颅脑损伤患者术后发生脑梗死的危险因素,需要采取合理措施降低其对患者预后的影响,提高患者的生活质量。Objective To explore risk factors related to cerebral infarction after traumatic brain injury. Methods A total of 800 cases after traumatic brain injury in this hospital during the period from June 2010 to June 2014 were selected for this study,and their age,gender,Glasgow Coma Scale（ Glasgow Coma Scale,GCS）,cerebral vasospasm,concurrent cerebral herniation,brain contusion,diabetes and blood pressure on admission and other clinical data of patients were retrospectively analyzed. Factors for cerebral infarction after traumatic brain injury were descriptively statistically analyzed with Logistic Regression analysis. Results Among these 800 cases,45 of them had cerebral infarction after traumatic brain injury with clinical data integrity,the incidence rate was 5. 63%,2 cases died,the mortality rate was 4. 44%,seven factors as age,GCS scores,cerebral vasospasm,complicated cerebral herniation,cerebral contusion,diabetes and low blood pressure had significant difference in statistical analysis（ P 0. 05） between these 2 groups. Multivariate Logistic Regression analysis showed younger age range,low GCS scores,lower systolic blood pressure,cerebral vasospasm,complicated cerebral herniation,and the type of brain damage with brain contusion,diabetes and low blood pressure and other factors had close relationship with cerebral infarction. Conclusion Younger age,low GCS scores,lower systolic blood pressure,cerebral vasospasm,complicated cerebral herniation,brain contusion in brain damage,diabetes,low blood pressure and other factors may be the risk factors responsible for cerebral infarction after traumatic brain injury,it is required to take reasonable measures to reduce its impact on the prognosis of patients and improve the quality of life of patients.

关 键 词：颅脑损伤 脑梗死 高危因素 

分 类 号：R651.15[医药卫生—外科学]