颅脑损伤后发生进展性出血性损伤的影响因素分析  

Analysis of factors influencing progressive hemorrhagic injury after traumatic brain injury

作　　者：康新[1] 伏光辉[1] KANG Xin;FU Guang-hui(Department of Neurosurgery,Lianyungang Eastern Hospital,Lianyungang 222042,China)

机构地区：[1]连云港市东方医院神经外科,222042

出　　处：《中国实用医药》2024年第19期45-47,共3页China Practical Medicine

摘　　要：目的 通过对比颅脑损伤患者的相关数据,为临床上针对颅内进展性出血性损伤寻找有效的影响因素,以便临床上及时干预提供理论支持。方法 分析90例颅脑损伤患者的临床资料,根据伤后10 h内是否出现颅内进展性出血性损伤分为进展组(n=38)与稳定组(n=52)。比较两组入院时CT征象异常率、发病到入院后首次CT时间、性别、年龄、入院格拉斯哥昏迷评分法(GCS)评分、凝血功能异常率,分析颅脑损伤后发生进展性出血性损伤的影响因素。结果 进展组入院时CT征象异常率76.3%、年龄(48.71±13.61)岁、凝血功能异常率73.7%大于稳定组的5.8%、(41.97±13.37)岁、21.2%,发病到入院后首次CT时间(1.05±0.36)h短于稳定组的(1.58±0.54)h,入院GCS评分(9.92±2.48)分低于稳定组的(11.35±2.71)分,差异有统计学意义(P<0.05)。两组女性占比比较,差异无统计学意义(P>0.05)。以是否发生进展性出血性损伤为因变量,差异有统计学意义的相关因素为自变量,经多因素Logistic回归分析显示:入院时CT征象异常、年龄、入院GCS评分、凝血功能异常是颅脑损伤后发生进展性出血性损伤的独立危险因素,发病到入院后首次CT时间是独立保护因素(P<0.05)。结论 颅脑损伤后颅内进展性出血性损伤的出现可能是由多种因素共同作用的结果 ,临床应重点关注其发生的各种影响因素,有利于预判进展性出血性损伤的发生。Objective By comparing the relevant data of patients with traumatic brain injury,to find effective early warning factors for intracranial progressive hemorrhagic injury in clinic,so as to provide theoretical support for clinical intervention.Methods The clinical data of 90 patients with traumatic brain injury were analyzed.According to whether there was progressive intracranial hemorrhagic injury within 10 h after injury,they were divided into progressive group(n=38)and stable group(n=52).The abnormal rate of CT signs on admission,the time from onset to first CT after admission,gender,age,Glasgow coma score(GCS)score on admission,and abnormal rate of coagulation function were compared between the two groups,and the influencing factors of progressive hemorrhagic injury after traumatic brain injury were analyzed.Results In the progressive group,the rate of abnormal CT signs on admission was 76.3%,the age was(48.71±13.61)years,the abnormal rate of coagulation function was 73.7%,which were greater than 5.8%,(41.97±13.37)years,and 21.2%in the stable group;the time from onset to first CT after admission of(1.05±0.36)h was shorter than(1.58±0.54)h in the stable group;the GCS score on admission of(9.92±2.48)points was lower than(11.35±2.71)points in the stable group;the difference was statistically significant(P<0.05).With the occurrence of progressive hemorrhagic injury as the dependent variable and the related factors with statistically significant differences as the independent variables,multivariate Logistic regression analysis showed that abnormal CT signs on admission,age,GCS score on admission,and abnormal coagulation function were independent risk factors for the occurrence of progressive hemorrhagic injury after traumatic brain injury,and the time from onset to first CT after admission was an independent protective factor(P<0.05).Conclusion The occurrence of progressive hemorrhagic injury after traumatic brain injury may be the result of multiple factors,and clinical attention should be paid to various ris

关 键 词：颅脑损伤 进展性出血性损伤 CT征象异常 预测 影响因素 

分 类 号：R651.15[医药卫生—外科学]