1026例颅脑交通伤合并多发伤患者的预后因素分析

摘要

Objective To analyze the distribution features of injury regions and severty of patients with traumatic brain injury ( TBI ) associated with muhiple injuries and discuss the influence of different injury regions and severity on their outcome. Methods Retrospective analysis was performed for clinical data of 1026 patients treated from August,2007 to August,2010. Results The majority of TBI patients associated with multiple injuries were young people( accounting for 78.07％ of the total injuries),among whom the males outnumbered females in proportion of 3.62:1,and the multiple injuries were mainly characterized by chest injuries (accounting for 46.69％ of multiple injuries).Spearman analysis indicated that Glasgow Outcome Scale (GOS) was correlated with Glasgow Coma Scale (GCS)score,age,maxillofacial region injuries,chest and abdomen injuries (P ＜ 0.05 ).Logistic regression analysis manifested that age,GCS score,and lung injury were the independent risk factors of high mortality in TBI patients associated with multiple injuries. Conclusion Low GCS scores,old age and severe lung injuries indicate a high mortality and morbidity,while injuries in extremities and pelvis have no significant influence on the outcome.%目的 分析颅脑交通伤合并多发伤患者损伤部位及其损伤程度的分布特点,探讨不同损伤部位及程度对此类患者预后的影响. 方法 回顾性分析2007年8月-2010年8月收治入院的1 026例颅脑交通伤合并多发伤患者的临床资料. 结果 患者以中青年居多(78.07％),且以男性为主(男女之比为3.62:1),合并伤以胸部损伤为主(46.69％).相关性分析表明GCS、年龄、颌面部损伤、胸腹损伤与GOS有相关性(P＜0.05),Logistic回归分析显示年龄、GCS、肺损伤是GOS的独立危险因素. 结论 低GCS评分、高龄、严重肺挫伤预示高死亡率和致残率,而四肢、骨盆等部位的损伤则对预后没有显著影响.