颅脑创伤术后长期预后的影响因素分析  

Analysis of influencing factors on long-term prognosis after craniocerebral trauma

作　　者：丁江波 王家雄 周磊 陈晓鹏 杨善宇 沈勇 DING Jiangbo;WANG Jiaxiong;ZHOU Lei;CHEN Xiaopeng;YANG Shanyu;SHEN Yong(Neurosurgery Department,Southern Central Hospital of Yunnan Province/First People's Hospital of Honghe Prefecture,Honghe Yunnan 661100,China;Rehabilitation Therapy of Dali University,Dali Yunnan 671013,China)

机构地区：[1]云南省滇南中心医院/红河州第一人民医院神经外科,云南蒙自661100 [2]大理大学康复治疗学专业,云南大理671013

出　　处：《云南医药》2023年第6期13-16,共4页Medicine and Pharmacy of Yunnan

摘　　要：目的 探究颅脑创伤手术治疗长期预后的影响因素。方法 连续收集2021年1月-2022年12月在本院接受手术治疗的124例成人创伤性颅脑损伤患者的临床资料和术前头颅CT影像资料。根据术后3月随访时MRS评分分为预后良好组(MRS评分<3)和预后不良组(MRS评分≥3),分析2组的一般临床资料和影像学资料。结果 术后3月MRS评分<3的65例(52.42%),≥3的59例(47.58%),死亡14例(11.29%)。单因素分析后,2组患者入院时GCS评分、瞳孔扩大例数、血肿位置、中线移位程度、合并脑室出血、合并基底池受压、术中去骨瓣例数等存在统计学差异(P<0.05);多因素分析后,入院时GCS评分(P<0.001)和术前合并脑室出血(P=0.018)是TBI手术治疗后长期预后不良的独立预测因素。结论 术前GCS评分和术前合并脑室出血是TBI手术治疗后长期预后不良的独立预测因素。Objective To explore the factors affecting the long-term prognosis after craniocerebral trauma.Methods The general clinical data and preoperative head CT image information of 124 adult patients with traumatic craniocerebral injury who were treated in our hospital from January 2021 to December 2022 were continuously collected.Patients were divided into good prognosis group(mRS<3)and poor prognosis group(mRS≥3)according to the mRS score at 3 months post-operative follow-up.The general clinical data and imaging data of patients in the two groups were analyzed.Results Three months after operation,65 cases(52.42%)had mRS score<3,59 cases(47.58%)≥3,and 14 cases(11.29%)died.After univariate analysis,there was statistical differences between the two groups in GCS at admission,the number of cases with dilated pupils,the location of hematoma,the degree of midline shift,combined with ventricular hemorrhage,combined with basal cistern compression and the number of cases with bone flap removal during operation(P<0.005).After multivariate analysis,GCS score at admission(P<0.001)and preoperative ventricular hemorrhage(P=0.018)were independent predictors of poor long-term prognosis after TBI surgery.Conclusions Preoperative GCS score and combined traumatic ventricular hemorrhage are independent predictors of poor long-term prognosis after TBI surgery.

关 键 词：创伤性颅脑损伤 影响因素 预后 

分 类 号：R651.15[医药卫生—外科学]