影响创伤性脑疝手术预后的相关危险因素分析  

Analysis of influencing factors on the prognosis after operation on traumatic brain hernia patients

作　　者：李昂[1] 张素巧[2] 李大鹏[1] 康军[3] 曹秋梅[1] 

机构地区：[1]首都医科大学附属北京同仁医院急诊科,北京100176 [2]中日友好医院急诊科,北京100029 [3]首都医科大学附属北京同仁医院神经外科,北京100176

出　　处：《中日友好医院学报》2016年第1期13-15,19,I0001,共5页Journal of China-Japan Friendship Hospital

摘　　要：目的：探讨影响创伤性脑疝患者手术预后的危险因素。方法：选取我院于2011年1月~2015年3月确诊为创伤性脑疝患者64例,均给予手术治疗,其中术后死亡的患者为36例,术后存活的患者为28例。研究影响患者手术预后的各种危险因素。结果：分析2组患者的一般情况,性别对于术后情况没有影响（P〉0.05）,而在年龄、GCS评分、手术时间、瞳孔反应和血肿类型等方面,均具有显著性差异（P〈0.05或P〈0.01）。经多因素回归分析确定,年龄≥60岁、GCS评分3~5分、术前时间≥2h、手术时间≥4h、双侧瞳孔散大、脑挫裂伴颅内血肿为术后预后不良的危险因素（P〈0.05或P〈0.01）。结论：对具有创伤性脑疝预后独立危险因素的患者,我们应根据不同人群给予特殊治疗措施,积极主动地进行预防及治疗。Objective：To explore the risk factors influencing the prognosis after operation on traumatic cerebral hernia patients.Methods：In our hospital from 2011 January to 2015 March,64 cases were diagnosed as traumatic brain hernia,were treated with operation treatment,in which 36 cases died after operation,postoperative survival of patients for 28 cases.Study on the effect of various risk factors of prognosis of patients after operation.Results：Analysis of the general situation of two groups of patients we found,gender has no effect on postoperative（P〉0.05）,and in the age,GCS score,operation time,hematoma and pupillary response type,with significant difference（P〈0.05 or P〈0.01）,can be regarded as prognostic factors of postoperative hernia.Age≥60years,GCS score 3~5 points,preoperative time≥2 hours,operation time≥4 hours,bilateral pupil scattered,brain sharp crack with intracranial hematoma were the risk factors for postoperative prognosis.Conclusion：The risk factors of traumatic brain hernia patients are age,GCS score,operation time,hematoma and pupillary response type.We should be based on individualized treatment measures,and actively carry out prevention and treatment.

关 键 词：创伤 脑疝 术后 危险因素 

分 类 号：R651.1[医药卫生—外科学]