颅脑外伤后发生嗅觉障碍的相关危险因素分析

摘要

Objective The risk factors of dysosmia after traumatic brain injury werer discussed.Methods A total of 80 patients with traumatic brain injury as the primary diagnosis in the Neurosurgery of Changzheng Hospital from January 2014 to December 2016 were included in this study and then were divided into olfactory damage group and normal olfactory group.Risk factors of dysosmia after traumatic brain injury were evaluated by analyzing the basic information of patients,causes of injury,Glasgow coma scale (GCS) score on admission,stressed sites,the existence of laceration,hematoma,edema and subarachnoid hemorrhage and the existence of skull base fracture and nasal bone fracture.Results There were 17 cases of dysosmia after traumatic brain injury,accounting for 21％ of the patients with traumatic brain injury.Univariate analysis showed that dysosmia was significantly associated with skull base fracture and contusion or hematoma or edema of frontal lobe,but there was no correlation between dysosmia and surgery,stressed sites,subarachnoid hemorrhage and contusion,hematoma or edema of the temporal andoccipitoparietal lobe.Conclusion We demonstrate that skull base fracture and contusion,hematoma or edema of frontal lobe could be the risk factors for the development of dysosmia after traumatic brain injury.There was no correlation between the development of dysautonomia and the GCS score on admission.%目的 探讨颅脑外伤后发生嗅觉障碍的相关危险因素分析.方法 本研究纳入了2014年1月至2016年12月长征医院神经外科收治的以颅脑外伤为主要诊断的患者共80例,分为嗅觉损伤组和嗅觉正常组.通过分析患者基本信息、受伤原因、入院格拉斯哥昏迷评分(GCS)、受力部位,是否存在脑挫裂伤、血肿、水肿,蛛网膜下腔出血等情况,是否存在颅底骨折、鼻骨等面颅骨折,评估颅脑外伤后发生嗅觉障碍的危险因素.结果 颅脑外伤后嗅觉障碍共17例,约占颅脑外伤患者的21％,单因素分析显示患者嗅觉障碍与颅底骨折,额叶的挫伤、血肿或水肿存在明显相关性,而与手术、受力部位、蛛网膜下腔出血、颞枕顶部脑挫裂伤、血肿或水肿无相关性.结论 额叶的挫裂伤、血肿和水肿以及颅底骨折是外伤后嗅觉障碍的相关危险因素,患者入院GCS评分等因素与嗅觉障碍的发生未显示出明显相关性.