急性颅脑损伤迟发性颅内血肿预后的影响因素分析

摘要

Objective To investigate the influence factors of prognois for delayed traumatic intracranial hema-toma (DTICH) in patients with acute brain injury. Methods Ninety-eight DTICH patients in our hospital from March 2010 to June 2014 were selected, Based on the prognosis of patients, the clinical data of the patients at admission were analyzed retrospectively, including Glasgow Coma Scale (GCS) score, nature of injury, combined injury, chronic diseas-es, hematoma type, complication, bleeding volume, history of chronic diseases, age. Results Among the 98 patients, 42 got good recovery and 17 died, with 21 of moderate disability, 10 of severe disability, 8 of persistent vegetative state (PVS). Single factor analysis showed that nature of injury, hematoma type, GCS score, complications, bleeding volume, history of chronic diseases, age were correlated with the prognosis of DTICH (P<0.05). Multi-factor logistic regression analysis showed that multiple hematoma, age over 60 years old, GCS score (3~8), and complications were the indepen-dent risk factors for poor prognosis of DTICH. Conclusion The DTICH in patients with acute craniocerebral injury is closely related to the number of hematoma, the age of patients, GCS score and complications.%目的 探讨影响急性颅脑损伤迟发性颅内血肿(DTICH)预后的相关因素.方法 选取我院2010年3月至2014年6月收治的98例急性颅脑损伤后DTICH患者,根据患者预后情况,回顾性分析其入院时GCS评分、受伤性质、合并伤、合并慢性病、血肿类型、合并并发症、DTICH出血量、伴慢性病史及年龄等因素.结果 98例患者中,恢复良好42例,中残21例,重残10例,植物生存8例,死亡17例;单因素分析结果表明,受伤性质、血肿类型、GCS评分、合并并发症、DTICH出血量、伴慢性病史、年龄等因素与DTICH预后有关(P<0.05);Logistic多因素分析显示,多发性血肿、年龄>60岁、GCS评分(3~8分)和合并并发症是导致DTICH预后差的独立危险因素.结论 急性颅脑损伤迟发性颅内血肿预后与血肿数量、患者年龄、入院时GCS评分及并发症密切相关.