颅脑创伤后脑血管痉挛发生的影响因素

摘要

Objective To investigate the influence factors of cerebral angiospasm of after craniocerebral trauma. Methods Totally 142 patients with craniocerebral trauma from November 2010 to November 2013 in our hospital were divided into con‐trol group (n=95, without cerebral angiospasm) and experimental group (n=47, with cerebral angiospasm). The influence factors of cerebral angiospasm of after craniocerebral trauma between two groups were compared. Results The occurrence rate of cerebral angiospasm in patients with high blood pressure, epidural hematoma and brain laceration, lower Glasgow coma scale, subarachnoid hemorrhage and Fisher GradeⅡ /Ⅲ was higher than that in patients without high blood pressure, subdural hematoma and skull fracture, higher Glasgow coma scale, without subarachnoid hemorrhage and Fisher grade Ⅰ, which had significant difference (P<0.05).Conclusion High blood pressure, damage type, Glasgow coma scale, subarachnoid hemor‐rhage and Fisher grade are independent risk factors of cerebral angiospasm after craniocerebral trauma.%目的：探讨颅脑创伤后脑血管痉挛发生情况及其影响因素。方法选取2010‐11—2013‐11诊治的颅脑创伤患者142例，根据脑血管痉挛发生情况分为2组，95例患者未发生脑血管痉挛为对照组，47例发生脑血管痉挛为观察组，分析颅脑创伤后脑血管痉挛的影响因素。结果高血压患者脑血管痉挛发生率明显高于无高血压患者。脑挫裂伤与硬膜外血肿患者脑血管痉挛发生率明显高于硬膜下血肿和颅骨骨折患者。格拉斯哥昏迷评分越低，患者发生脑血管痉挛的几率越高。蛛网膜下腔出血患者脑血管痉挛发生率明显高于无蛛网膜下腔出血患者。Fisher分级Ⅱ级／Ⅲ级的患者脑血管痉挛发生率明显高于Fisher分级Ⅰ级患者，差异均有统计学意义（P＜0.05）。结论高血压、损伤类型、格拉斯哥昏迷评分、蛛网膜下腔出血、Fisher分级均是颅脑创伤后脑血管痉挛的独立危险因素。