重度颅脑外伤并发创伤性脑梗死的相关危险因素分析

Risk factors for post-traumatic cerebral infarction in patients with severe traumatic brain injury

关键词:  创伤性脑梗死  颅脑损伤  危险因素  Logistic回归分析

Key words:  post-traumatic cerebral infarction  traumatic brain injury  risk factor  logistic regression analysis

摘要:

目的　探讨重度颅脑外伤并发创伤性脑梗死（PTCI）的相关危险因素，为PTCI预防和治疗提供参考。方法　对206例重度颅脑外伤患者的临床资料进行回顾性分析，将患者分为PTCI组和非PTCI组，对可能造成PTCI的13项因素进行Logistic回归分析，筛选出并发PICI的相关危险因素。结果　单因素结果显示：低GCS评分、创伤性蛛网膜下腔出血(tSAH)、脑疝、低收缩压和去骨瓣减压术在PTCI组显著高于非PTCI组(P<0.05 )。多因素Logistic逐步回归分析后得出：tSAH、低收缩压和脑疝是PTCI发生的危险因素(OR分别为3.661、3.843和1.259，P<0.05 )。结论　tSAH、低收缩压和脑疝是重度颅脑外伤并发PTCI的危险因素，对这些危险因素加以重点评估和合理控制对于防治PTCI的发生有重要的临床意义。

Abstract:

Objective 　To study the risk factors for post-traumatic cerebral infarction (PTCI) in patients with severe traumatic brain injury. 　Methods 　The clinical data of 206 consecutive cases of severe traumatic brain injury were analyzed retrospectively. The patients were classified into PTCI groups and non-PTCI groups. The risk factors for the development of PTCI were evaluated by logistic regression method. 　Results 　The single-factor analysis showed that Poor admission GCS, low systolic BP, traumatic subarachnoid hemorrhage (tSAH), brain herniation and decompression craniotomy in the PTCI group were significantly higher than in the non-PTCI group. Multivariate logistic regression analysis showed tSAH, low systolic BP and brain herniation were the risk factors of PTCI (OR=3.661, 3.843 and 1.259, respectively; P<0.05). 　Conclusion 　tSAH, low systolic BP and brain herniation may be risk factors for PTCI in patients with severe traumatic brain injury.