摘要
目的探讨分析闭合性颅脑损伤患者并发进展性出血性损伤(PHI)临床特征及危险因素。方法选取2015年1月—2017年2月收治的143例未行急诊手术治疗的闭合性颅脑损伤患者进行研究。根据颅内是否发生PHI分为进展组(并发PHI)46例与非进展组(未并发PHI)97例。回顾性分析两组的临床资料,并采用Logistic回归分析闭合性颅脑损伤患者发生PHI的危险因素。结果两组年龄、入院时格拉斯哥昏迷量表(GCS)评分、两次CT血肿量差、合并颅骨骨折、意识障碍、瞳孔扩大、D-二聚体(D-D)和血小板(PLT)计数比较差异有统计学意义(P<0.05)。年龄>50岁、入院时GCS评分<12分、两次CT血肿量差>20 ml、意识障碍、瞳孔扩大、D-D>1.24 mg/L、PLT>300×109/L是闭合性颅脑损伤患者发生PHI的独立危险因素(P<0.05)。结论针对上述危险因素,临床应尽早发现,早期处理和预防,可以有效降低闭合性颅脑损伤患者PHI的发生率,改善预后生活质量。
Objective To investigate and analyze clinic features and risk factors in patients with closed craniocerebral injury combined with progressive hemorrhagic injury(PHI).Methods A total of143closed craniocerebral injury patients without having emergency operation between January2015and February2017were divided into progression group(combined with PHI,n=46)and non progressive group(non complicated with PHI,n=97)according to whether having intracranial PHI or not.Clinical data of two groups was retrospectively analyzed,and risk factors of PHI pathogenesy in patients with closed craniocerebral injury were analyzed by Logistic regression analysis.Results There were significant differences in age,Glasgow coma scale(GCS)score at the time of admission,two times difference of CT hematoma volumes,combined with skull fracture,consciousness disorder,pupil dilation,D-dimer(D-D)and platelet(PLT)count between two groups(P<0.05).Age more than50years old,GCS score less than12points at the time of admission,two times difference of CT hematoma volumes more than20ml,disturbance of consciousness,pupil dilation,D-D more than1.24mg/L,PLT more than300×109/L were independent risk factors of PHI in patients with closed craniocerebral injury(P<0.05).Conclusion Clinicians should find as early as possible and give treatment and prevention in early period according to the above risk factors for patients with closed craniocerebral injury combined with progressive hemorrhagic injury,and then incidence rate of PHI can be effectively reduced,and prognosis and quality of life can be improved.
作者
张雄新
李玉雄
ZHANG Xiong-xin;LI Yu-xiong(Department of Neurosurgery,Yulin Hospital of Traditional Chinese Medicine,Yulin,Shaanxi 719000,China)
出处
《解放军医药杂志》
CAS
2017年第12期49-52,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省科学技术研究发展计划项目(2013k12_01_23)
关键词
颅脑损伤
进展性出血性损伤
危险因素
Craniocerebral Trauma
Progressive hemorrhagic injury
Risk factors
