弥漫性轴索损伤远期预后影响因素分析  

Analysis of factor related to prognosis in patients with diffuse axonal injury

作　　者：姚顺[1] 吴敏[2,3] 宋健[1] 曹成龙[1,4] 房莉[1] 何志远[1] 孙荣辉[1] 杜浩[1] 徐国政[1] 

机构地区：[1]中国人民解放军武汉总医院神经外科,武汉430070 [2]浙江大学医学院附属第一医院神经内科,杭州310003 [3]浙江大学医学院 [4]南方医科大学

出　　处：《中国临床神经外科杂志》2016年第11期661-663,693,共4页Chinese Journal of Clinical Neurosurgery

基　　金：全军医学科技"十二五"重点项目(BWS11J066)

摘　　要：目的 探讨弥漫性轴索损伤（DAI）远期预后的影响因素。方法 回顾性分析2010年1月至2015年5月收治的236例DAI的临床资料,伤后6个月,采用GOS评估远期预后。采用多因素Logistic回归分析检验影响因素。结果 236例中,死亡29例（12.3%）,植物生存或仅有最小意识反应18例（7.6%）,重残42例（17.8%）,中残38例（16.1%）,恢复良好109例（46.2%）。预后良好（GOS评分4～5分）147例（62.3%）,预后不良（GOS评分1～3分）89例（37.7%）。多因素Logistic回归分析结果显示,年龄、运动评分、瞳孔反应和Levi-CT分级是评估DAI患者远期预后的独立良好指标。结论 年龄〉60岁、运动评分1～2分、瞳孔异常和Levi-CT分级Ⅱ～Ⅲ级是DAI患者远期预后不良的独立危险因素。Objective To investigate the independent predictors of long-term outcome in the patients with diffuse axonal injury （DAI）. Methods The clinical data of 236 patients with DAI, who were treated in our hospital from January, 2010 to May, 2015, were analyzed retrospectively. The factors related to the prognosis in the patients with DAI were analyzed respectively by univariate analysis and multivariate logistic regression analysis. Results Of 236 patients with DAI, 147 had good prognoses （GOS. 4-5 scores） and 89 poor （GOS 1-3 scores） 6 months after the treatment. The univariate analysis showed that the factors related to the prognosis included age, GCS, motor score, pupillary reactivity, Levi CT Scoring, Babinski＇s sign, body temperature and blood glucose level in the patients with DAI. The multivariate logistic regression analysis showed that the independent factors influencing the prognosis included age, motor score, pupillary reactivity and Levi CT scoring in the patients with DAI. Conclusions Age 〉60 years, motor score 〈3 points, abnormal pupillary reactivity and Levi CT scoring ≥ grade 2 are independent risk factors related to the poor prognosis in the patients with DAI.

关 键 词：弥漫性轴索损伤 远期预后 影响因素 LOGISTIC回归分析 

分 类 号：R651.15[医药卫生—外科学]