摘要
目的探究颅脑损伤(CI)患者早期死亡预测因素及其临床价值。方法将1102例CI患者作为本次研究对象,统计CI患者的病例资料,并与早期死亡进行相关性分析;Logistic回归分析筛选出与CI患者早期死亡最密切的预测因素。结果统计结果显示1102例研究对象中约9.4%发生抢救无效死亡。多因素分析以下几组数据均具有统计学意义:瞳孔反应异常(OR=4.669,P<0.05)、大脑中线偏移(OR=7.898,P<0.001)、脑疝形成(OR=8.013,P<0.001)、低格拉斯哥昏迷评分(GCS)(OR=3.847,P<0.001)、脑多发伤(OR=6.354,P<0.01)、血糖异常(OR=6.574,P<0.01)、凝血功能异常(OR=5.281,P<0.01)与患者早期死亡的敏感预测因素。结论CI患者瞳孔直接及间接反射迟钝或消失、大脑中线偏移、脑疝形成、低GCS评分、血糖异常、凝血异常、脑多发伤与CI早期死亡呈正相关,尽早积极干预可有效增加CI患者生存率。
Objective The predictive factors of early death in patients with craniocerebral injury(CI)were analyzed to provide a reference for clinical treatment.Methods Collected clinical data from 1102 patients with craniocerebral injury and admitted into the Department of Neurological Surgery,First Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2014 to December 2019,and analyzed the correlation of general data,injuries,and auxiliary examinations that may affect patients'early death,Using multi-factor Logistic regression analysis to influence the predictive factors of early death in patients with craniocerebral injury.Results Among them,104 CI patients died after early rescue,accounting for 9.4%of the total number.Abnormal pupil responses(OR=4.669,P<0.05),midline shift(OR=7.898,P<0.001),brain herniation(OR=8.013,P<0.001),lower GCS score(OR=3.847,P<0.001),multiple trauma(OR=6.354,P<0.01),coagulopathy(OR=5.281,P<0.01),and abnormal blood sugar(OR=6.574,P<0.01)are risk factors for early death.Conclusions Patients with low GCS score,slow or absent pupil light reflex,midline deviation,cerebral hernia,abnormal blood glucose and abnormal blood coagulation and multiple injuries are predictive factors for early death of craniocerebral injury,early intervention is encouraged as a tackling to the challenge.
作者
刘家维
张毅
王凯
马文娟
LIU Jia-wei;ZHANG Yi;WANG Kai;MA Wen-juan(the First Clinical Medical College, Shaanxi University of Chinese Medicine,Xianyang 712046;Department of Neurological Surgery, the First Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712046;Department of Rehabilitation Medicine, Xianyang Central Hospital, Xianyang 712046, China)
出处
《基础医学与临床》
2021年第12期1797-1801,共5页
Basic and Clinical Medicine
基金
国家自然科学基金(81873288)
陕西省中医脑病临床医学研究中心建设项目(201704)
陕西中医药大学学科创新团队项目(2019-YL15)。
关键词
颅脑损伤
死亡
预测因素
分析
craniocerebral injury
death
predictive factors
analysis
