创伤性颅脑损伤患者发生急性胃肠道功能衰竭的危险因素分析  

Analysis of risk factors of acute gastrointestinal failure in patients with traumatic brain injury

作　　者：肖红波 贾根来 陈三军 陈长兵 Xiao Hongbo;Jia Genlai;Chen Sanjun;Chen Changbing(Department of Neurosurgery,Rugao Hospital Affiliated to Nantong University,Rugao 226500,China)

机构地区：[1]南通大学附属如皋医院神经外科,如皋226500

出　　处：《中国医师进修杂志》2022年第10期914-917,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨创伤性颅脑损伤(TBI)患者发生急性胃肠道功能衰竭的危险因素。方法回顾性分析南通大学附属如皋医院2018年3月至2020年3月因TBI入院治疗的297例患者的临床资料,采用多因素Logistic回归分析发生急性胃肠道功能衰竭的危险因素。结果297例TBI患者中,92例(30.98%)并发急性胃肠道功能衰竭,其中56例(18.86%)为急性胃肠道损伤Ⅲ级,36例(12.12%)为Ⅳ级。多因素Logistic回归分析显示女性、格拉斯哥昏迷量表(GCS)评分低、额叶损伤、血清钠异常、肺部感染及颅内感染是TBI患者发生急性胃肠道功能衰竭的独立危险因素(P<0.05)。急性胃肠道功能衰竭组ICU住院时间长于非急性胃肠道功能衰竭组[(18.5±2.6)d比(6.3±1.2)d],预后良好发生率低于非急性胃肠道功能衰竭组[60.87%(56/92)比80.49(165/205)],差异均有统计学意义(P<0.05)。结论女性、GCS评分低、额叶损伤、血清钠异常、肺部感染及颅内感染是TBI患者发生急性胃肠道功能衰竭的独立危险因素。Objective To investigate the risk factors of acute gastrointestinal failure in patients with traumatic brain injury(TBI).Methods A retrospective analysis of 297 patients admitted to the Rugao Hospital Affiliated to Nantong University for traumatic brain injury from March 2018 to March 2020 was performed.Multivariate Logistic regression analysis was used to test the risk factors of acute gastrointestinal failure in patients with traumatic brain injury.Results Of the 297 patients with TBI,92(30.98%)had acute gastrointestinal failure,of which 56(18.86%)were acute gastrointestinal injury(AGI)Ⅲand 36(12.12%)were AGIⅣ.Multivariate Logistic regression analysis showed that female,low Glasgow Coma Scale(GCS)scores,frontal lobe injury,abnormal serum sodium,lung infection and intracranial infection were independent risk factors for acute gastrointestinal failure in TBI patients(P<0.05).The length of ICU stay in the acute gastrointestinal failure group was significantly higher than that of the non-acute gastrointestinal failure group:(18.5±2.6)d vs.(6.3±1.2)d,and the incidence of good prognosis was significantly lower than that of the non-acute gastrointestinal failure group:60.87%(56/92)vs.80.49(165/205),the differences were statistically significant(P<0.05).Conclusions That female,low GCS scores,frontal lobe injury,abnormal serum sodium,lung infection and intracranial infection are independent risk factors for acute gastrointestinal failure in TBI patients.

关 键 词：颅脑损伤 危险因素 急性胃肠道功能衰竭 

分 类 号：R651.15[医药卫生—外科学]