基础医学与临床 ›› 2021, Vol. 41 ›› Issue (12): 1797-1801.

• 临床研究 • 上一篇    下一篇

颅脑损伤患者早期死亡的预测因素

刘家维1, 张毅2, 王凯1, 马文娟3*   

  1. 1.陕西中医药大学 第一临床医学院,陕西 咸阳 712046;
    2.陕西中医药大学第一附属医院 神经外科,陕西 咸阳 712046;
    3.咸阳市中心医院 康复医学科,陕西 咸阳 712046
  • 收稿日期:2020-08-18 修回日期:2021-01-09 发布日期:2021-12-03
  • 通讯作者: *369516852@qq.com
  • 基金资助:
    国家自然科学基金(81873288); 陕西省中医脑病临床医学研究中心建设项目(201704); 陕西中医药大学学科创新团队项目(2019-YL15)

Predictive factors of early death in patients with craniocerebral injury

LIU Jia-wei1, ZHANG Yi2, WANG Kai1, MA Wen-juan3*   

  1. 1. the First Clinical Medical College, Shaanxi University of Chinese Medicine,Xianyang 712046;
    2. Department of Neurological Surgery, the First Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712046;
    3. Department of Rehabilitation Medicine, Xianyang Central Hospital, Xianyang 712046, China
  • Received:2020-08-18 Revised:2021-01-09 Published:2021-12-03
  • Contact: *369516852@qq.com

摘要: 目的 探究颅脑损伤(CI)患者早期死亡预测因素及其临床价值。方法 将1 102例CI患者作为本次研究对象,统计CI患者的病例资料,并与早期死亡进行相关性分析;Logistic回归分析筛选出与CI患者早期死亡最密切的预测因素。结果 统计结果显示1 102例研究对象中约9.4%发生抢救无效死亡。多因素分析以下几组数据均具有统计学意义:瞳孔反应异常(OR=4.669,P<0.05)、大脑中线偏移(OR=7.898,P<0.001)、脑疝形成(OR=8.013,P<0.001)、低格拉斯哥昏迷评分(GCS)(OR=3.847,P<0.001)、脑多发伤(OR=6.354,P<0.01)、血糖异常(OR=6.574,P<0.01)、凝血功能异常(OR=5.281,P<0.01)与患者早期死亡的敏感预测因素。结论 CI患者瞳孔直接及间接反射迟钝或消失、大脑中线偏移、脑疝形成、低GCS评分、血糖异常、凝血异常、脑多发伤与CI早期死亡呈正相关,尽早积极干预可有效增加CI患者生存率。

关键词: 颅脑损伤, 死亡, 预测因素, 分析

Abstract: Objective The predictive factors of early death in patients with craniocerebral injury (CI) were analyzed to provide a reference for clinical treatment. Methods Collected clinical data from 1 102 patients with craniocerebral injury and admitted into the Department of Neurological Surgery, First Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2014 to December 2019, and analyzed the correlation of general data, injuries, and auxiliary examinations that may affect patients' early death, Using multi-factor Logistic regression analysis to influence the predictive factors of early death in patients with craniocerebral injury. Results Among them, 104 CI patients died after early rescue, accounting for 9.4% of the total number. Abnormal pupil responses (OR=4.669, P<0.05), midline shift (OR=7.898, P<0.001), brain herniation (OR=8.013, P<0.001),lower GCS score (OR=3.847, P<0.001), multiple trauma (OR=6.354, P<0.01), coagulopathy (OR=5.281, P<0.01), and abnormal blood sugar (OR=6.574, P<0.01) are risk factors for early death. Conclusions Patients with low GCS score, slow or absent pupil light reflex, midline deviation, cerebral hernia, abnormal blood glucose and abnormal blood coagulation and multiple injuries are predictive factors for early death of craniocerebral injury, early intervention is encouraged as a tackling to the challenge.

Key words: craniocerebral injury, death, predictive factors, analysis

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