摘要
目的探讨颅脑创伤(TBI)患者垂体功能减退的发病率及相关危险因素。方法回顾性分析198例颅脑创伤患者的临床资料。依据是否发生垂体功能减退,将患者分为垂体功能减退组与正常组;分析比较两组患者的相关临床指标。结果本组患者中42例患者出现垂体功能减退,156例患者垂体功能正常。单因素分析显示,入院时格拉斯哥昏迷量表GCS评分、颅内压≥20 mmHg、头颅CT中线移位≥5 mm、颅底骨折、ICU住院天数及总住院天数与颅脑创伤后垂体功能减退有关。多因素Logistic回归分析显示,颅内压≥20 mmHg(OR=3.495,P=0.022)、头颅CT显示中线移位≥5 mm(OR=6.882,P=0.003)、GCS评分≤8(OR=2.482,P=0.039)是颅脑创伤患者发生垂体功能减退的独立危险因素。结论颅脑创伤后患者垂体功能减退的发病率较高。颅内压≥20 mmHg、头颅CT中线移位≥5 mm、GCS评分≤8是颅脑创伤后垂体功能减退的独立危险因素;应加强对这类患者的垂体功能评估,并进行激素替代治疗,改善预后。
Objective To determine the prevalence and risk factors of hypopituitarism in patients with traumatic brain injury(TBI).Methods The clinical data of 198 TBI patients were retrospectively analyzed.The patients were divided into hypopituitarism group and non-hypopituitarism group,and the related clinical indicators were compared between 2 groups.Results Forty two patients were diagnosed with hypopituitarism,while 156 patients were diagnosed with normal pituitary function.Univariate analysis showed that GCS score at admission,intracranial pressure(≥20 mmHg),midline shift(≥5 mm),length of ICU stay,skull base fracture and total length hospital stay were associated with hypopituitarism.Logistic regression analysis showed that intracranial pressure≥20 mmHg(OR=3.495,P=0.022),midline shift≥5 mm(OR=6.882,P=0.003)and GCS score≤8(OR=2.482,P=0.039)were independent risk factors for posttraumatic hypopituitarism.Conclusions The incidence of hypopituitarism after TBI is high.Intracranial pressure≥20 mmHg,midline shift≥5 mm and GCS score≤8 were independent risk factors for posttraumatic hypopituitarism.Routine pituitary function evaluation and hormone replacement therapy are indicated for this group of patients.
作者
孙振国
杨阳
孙建新
王诗荃
姜德华
SUN Zhen-guo;YANG Yang;SUN Jian-xin(Department of Neurosurgery, Xuzhou Central Hospital, Xuzhou 221009, China)
出处
《临床神经外科杂志》
CAS
2020年第6期711-713,共3页
Journal of Clinical Neurosurgery
