不同部位脑外伤患者认知障碍特征差异性及其发病的危险因素分析  

Variability of cognitive impairment characteristics in patients with traumatic brain injury at different sites and the risk factors for its development

作　　者：马欢欢[1] 门秀娟 林文秀 MA Huan-huan;MEN Xiu-juan;LIN Wen-xiu(Department of Rehabilitation Medicine,Fuyang People's Hospital,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市人民医院康复医学科,安徽阜阳236000

出　　处：《临床和实验医学杂志》2025年第2期161-164,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽省自然科学基金面上项目(编号:2308085MH298)。

摘　　要：目的分析不同部位脑外伤患者认知障碍特征差异性及其发病的危险因素。方法回顾性选取2021年7月至2024年7月阜阳市人民医院收治的198例脑外伤患者为研究对象,依据蒙特利尔认知评估量表(MoCA)分为认知障碍组(n=90)和无认知障碍组(n=108)。统计脑外伤分布情况,比较不同部位脑外伤患者认知障碍特征。收集研究对象入院后的病例资料(性别、年龄、体重指数、脑外伤原因、一氧化碳中毒、脑梗死、烟雾病、帕金森、糖尿病、脑损伤程度、高血压、代谢性脑病、外伤后昏迷)。单因素和多因素Logistic回归分析影响脑外伤患者认知障碍的因素。结果90例脑外伤认知障碍患者脑外伤部位分别为小脑外伤9例,额叶外伤23例,基底节、顶叶、丘脑外伤均10例,颞叶外伤17例,枕叶外伤11例。不同部位脑外伤患者在计算和定向力、注意与集中、记忆、视结构技能、抽象思维、执行功能、语言、MoCA总分方面比较,差异均有统计学意义(P<0.05)。两组性别、年龄、体重指数、脑外伤原因、一氧化碳中毒、烟雾病、糖尿病结果比较,差异均无统计学意义(P>0.05);脑外伤认知障碍组脑梗死、帕金森、脑损伤程度重度、高血压、代谢性脑病、外伤后昏迷占比均高于无认知障碍组,差异均有统计学意义(P<0.05)。多因素回归分析显示,脑梗死(OR=1.602,95%CI:1.051~2.441)、帕金森(OR=1.711,95%CI:1.214~2.411)、脑损伤程度(OR=1.631,95%CI:1.126~2.362)是脑外伤患者认知障碍的独立危险因素(P<0.05)。结论不同部位脑外伤患者认知障碍特征差异性明显,脑梗死、帕金森、脑损伤程度是脑外伤患者认知障碍危险因素,临床可用于脑外伤患者认知障碍的预测。thinking,executive function,language,and MoCA total score(P<0.05).There were no statistically significant differences in gender,age,body mass index,cause of brain trauma,carbon monoxide poisoning,moyamoya disease and diabetes between the two groups(P>0.05).The proportions of cerebral infarction,Parkinson's disease,severe brain injury,hypertension,metabolic encephalopathy and post-traumatic coma in the cognitive impairment group were higher than those in the non-cognitive impairment group,and the differences were statistically significant(P<0.05).Multifactorial regression analysis showed that cerebral infarction(OR=1.602,95%CI:1.051-2.441),Parkinson's(OR=1.711,95%CI:1.214-2.411),and the degree of brain injury(OR=1.631,95%CI:1.126-2.362)were the independent risk factors for traumatic brain injuries with cognitive impairment(P<0.05).Conclusion The variability of cognitive impairment characteristics in patients with traumatic brain injury in different parts of the brain is obvious,and cerebral infarction,Parkinson's,and the degree of brain injury are the risk factors for cognitive impairment in patients with traumatic brain injury,which can be clinically used to predict cognitive impairment in patients with traumatic brain injury.

关 键 词：脑外伤 认知障碍 差异性 危险因素 脑梗死 帕金森 脑损伤程度 

分 类 号：R651.15[医药卫生—外科学] R749.1[医药卫生—临床医学]