颅底创伤对阵发性交感神经过度兴奋患者的临床结局影响  

Clinical outcome of skull base trauma in patients with paroxysmal sympathetic hyperactivity

作　　者：齐恩博 吕立权 王君玉 侯立军 QI Enbo;LV Liquan;WANG Junyu;HOU Lijun(Department of Neurosurgery, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, Chin)

机构地区：[1]海军军医大学长征医院神经外科,上海200003

出　　处：《中华神经外科疾病研究杂志》2018年第2期151-154,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(81371382)

摘　　要：目的探讨颅底创伤与阵发性交感神经过度兴奋(PSH)发生的关系以及对PSH患者的临床结局影响。方法本研究纳入了2014年1月至2016年12月长征医院神经外科重症监护室(ICU)内以颅脑外伤作为主要诊断的患者资料共127例,分为颅底创伤组和对照组。通过分析患者基本信息,住院期间感染情况,住院ICU时间、住院时间及患者出院ICU后12个月时格拉斯哥预后评分(GOS),评估颅底创伤对PSH患者的预后影响。结果作为基线水平,两组患者的年龄、性别结果无统计学差异(P>0.05);而颅底创伤组的格拉斯哥昏迷评分(GCS)、住院ICU时间、住院时间与对照组存在明显差异(P<0.05),颅底创伤组发生感染的风险较对照组明显增加,随访颅底创伤组12个月后GOS评分较对照组偏低,但无统计学差异(P>0.05)。结论颅底创伤可能是导致外伤患者发生PSH的原因之一。不论是住院期间还是远期预后,颅底创伤对合并有PSH的外伤患者产生了不良影响。Objective The clinical outcome of skull base trauma in patients with paroxysmal sympathetic hyperactivity（PSH） was investigated. Methods A total of 127 patients with craniocerebral trauma as the primary diagnosis in the neurosurgery intensive care unit（ICU） of Changzheng Hospital from January 2014 to December 2016 were included in this study and then were divided into skull base trauma group and control group. The prognosis of traumatic patients with PSH was evaluated by analyzing the basic information,the infection during hospitalization,ICU length of stay,hospitalization time and Glasgow outcome scale（GOS） score at 12 months after ICU discharge.Results There was no significant difference of age and sex between two groups（P〈0. 05）. The Glasgow coma scale（GCS） score,ICU time and hospitalization time in the skull base trauma group were significantly different from those in the control group（P〈0. 05）. And the risk of infection in skull base trauma group was significantly higher than that in the control group. The GOS score of skull base trauma group after 12 months was lower than that in the control group,but there was no significant difference（P〈0. 05）. Conclusion Skull base trauma may be one of the causes of PSH in traumatic patients. Skull base trauma has an adverse effect on patients with PSH associated with craniocerebral trauma whether during hospitalization or long-term prognosis.

关 键 词：颅脑外伤 颅底创伤 阵发性交感神经过度兴奋 临床结局 预后 

分 类 号：R651.15[医药卫生—外科学]