老年人额叶挫裂伤病情进展恶化的危险因素分析  

Analysis of the related risk factors for progress of the elderly frontal lobe contusions

作　　者：周世聪[1] 贾强[1] 周贤文[1] 王宗宝[1] 潘增军[1] 

机构地区：[1]滨州市中心医院神经外科,山东省滨州251700

出　　处：《中国基层医药》2016年第10期1530-1533,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨老年人额叶挫裂伤病情进展恶化的相关危险因素。方法回顾性分析滨州市中心医院神经外科2012年8月至2014年8月收治的额叶挫裂伤患者235例（其中老年人额叶挫裂伤118例）的临床资料。118例患者入院后给予常规治疗，并动态复查脑 CT。病情进展患者常规行冠状入路、单额或者双额骨瓣行挫伤脑组织清除术；病情未进展患者继续行常规保守治疗方案。选取患者合并高血压、口服阿司匹林、合并糖尿病、对冲伤、库欣反应、侧裂池是否存在及合并硬膜下血肿共7个指标进行统计学分析。结果该组118例患者，其中68例（57．6％）患者治疗中出现病情进展，50例（42．4％）患者病情未进展。统计学分析结果提示口服阿司匹林（P ＝0．006）、侧裂池是否存在（P ＝0．001）、库兴反应（P ＝0．025）为老年人额叶挫裂伤病情进展恶化的独立危险因素。结论对于老年额叶挫裂伤患者，口服阿司匹林、侧裂池是否存在、是否存在库欣反应这3个因素，是病情进展恶化的危险因素。如果出现以上一个或者多个危险因素后临床需要密切观察，谨防病情进展恶化。Objective To investigate the related risk factors for progress of the elderly frontal lobe contusions. Methods The clinical data of 118 cases of elderly frontal lobe contusions from August 2012 to August 2014 were retrospectivelyanalyzed.118 patients were given conventional therapy after admission,received dynamic review of brain CT.The progress of patients were performed surgery of frontal coronary approach,removed contusion brain tissue by bone flap of single frontal or double the frontal lobe.No progress of patients were given conventional conservative treat-ment.Selected seven indicators combining with hypertension,oral aspirin,diabetes mellitus,contrecoup injury,Cushing response,sylvian cistern exist or not and subdural hematoma did a statistical analysis.Results This group of 118 patients,68 cases （57.6%）had progress and 50 cases （42.4%）had no progress.Statistical analysis showed that oral aspirin （P =0.006 ）,sylvian cistern exist or not （P =0.001 ）,Cushing response （P =0.025 ）were independent risk factors of progress of the elderly frontal lobe contusions.Conclusion For elderly patients with fron-tal lobe contusion,oral aspirin,sylvian cistern exist or not,whether there is any Cushing response were risk factors for deterioration of disease progression.If one or more risk factors appeared,clinical need to prevent disease progression.

关 键 词：颅脑损伤 老年人 额叶挫裂伤 危险因素 

分 类 号：R651.15[医药卫生—外科学]