儿童颅脑外伤致伤因素及入住ICU的危险因素分析  

Causes for children with traumatic brain injury and risk factors analysis of ICU admission

作　　者：段闪闪 廖灯彬[1] 王科 文翕 侯晓玲 DUAN Shan-shan;LIAO Deng-bin;WANG Ke;WEN Xi;HOU Xiao-ling(West China Hospital/West China School of Nursing,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院/四川大学华西护理学院,四川成都610041

出　　处：《实用医院临床杂志》2021年第3期170-175,共6页Practical Journal of Clinical Medicine

摘　　要：目的分析颅脑外伤患儿的主要致伤因素,探究其入住ICU的相关危险因素。方法选取2019年1月1日至2020年9月30日就诊于我院创伤医学中心的157例颅脑外伤患儿,分析不同年龄组患儿的主要致伤因素,并探究颅脑外伤患儿入住ICU的相关危险因素。结果157例颅脑外伤患儿中,男女比例约2∶1,主要的致伤因素为跌倒/摔伤(44.59%),其次为车祸伤(24.84%)和高坠伤(20.38%)。不同年龄段患儿的主要致伤因素不同,其GOS预后评分也不同,差异均有统计学意义(P<0.05)。经多因素Logistic回归分析显示,致伤因素、瞳孔对光反射情况、使用呼吸机、四肢抽搐和手术治疗为影响患儿入住ICU的独立危险因素。结论因儿童活泼好动,自我保护意识及能力较差,颅脑外伤较容易发生,男性患儿明显多于女性患儿,跌倒/摔伤、车祸伤和高坠伤是其主要致伤因素,且不同年龄段的主要致伤因素不同;与成人相比,儿童颅脑外伤以轻型多见,死亡率较低,预后相对较好。同时,致伤因素、瞳孔对光反射情况、使用呼吸机、四肢抽搐和手术治疗为影响患儿入住ICU的独立危险因素。Objective To analyze the main injury causes for children with traumatic brain injury and to explore the related risk factors for children admitted to ICU.Methods A retrospective analysis was conducted on the clinical data of 157 children with traumatic brain injury in the trauma center of our hospital from January 1,2019 to September 30,2020.The main injury factors of children in different age groups with traumatic brain injury wereanalyzed and the related risk factors for children admitted to ICU were explored.Results Among 157 children with traumatic brain injury,the ratio of male to female was about 2∶1.The main injury factors were falls/tumble(44.59%)followed by traffic accident(24.84%)and high-fall injuries(20.38%).The main injuring factors were different in different age groups,and the GOS prognosis score was different(P<0.05).Multivariate logistic regression analysis showed that injury factors,pupil reflectance to light,ventilator use,limb convulsion and surgical treatment were independent risk factors for ICU admission.Conclusion Children are active and poor self-protection awareness and ability,so that traumatic brain injury is more likely to occur.Male children are more than female children.Fall/tumble injury,car accident injury and high-fall injury are the main injury factors.The main injury factors are different in different age groups.Compared with adults,mild traumatic brain injury is more common in children with lower mortality and better prognosis.At the same time,the injury factors,pupil reflectance to light,ventilator use,limb convulsion and surgical treatment are independent risk factors for ICU admission.

关 键 词：颅脑外伤 致伤因素 儿童 ICU 多因素LOGISTIC回归分析 

分 类 号：R726[医药卫生—儿科] R47[医药卫生—临床医学]