摘要: 目的 探讨开放性颅脑创伤后早期癫发作危险因素,并提出初步预防措施。方法 对2006 年9 月-2009 年9 月诊断与治疗的91 例开放性颅脑创伤患者的临床资料进行单因素及多因素Logistic 逐步回归分析,筛选颅脑创伤后早期癫痫发作之危险因素。结果 单因素分析显示,年龄(χ2 =5.131,P = 0.023)、颅脑创伤分型(χ2 = 6.302,P = 0.043)、损伤部位(χ2 = 12.800,P = 0.046),以及伴发脑挫裂伤(χ2 = 7.187,P = 0.007)、外伤性蛛网膜下隙出血(χ2 = 11.092,P = 0.001)、颅内血肿(χ2 = 6.555,P =0.010)和凹陷性骨折(χ2 = 8.463,P = 0.043)等项因素与开放性颅脑创伤后早期癫痫发作显著相关。进一步Logistic 逐步回归分析,仅年龄(OR = 7.719,95%CI = 1.129 ~ 52.777;P = 0.037)、脑挫裂伤(OR = 28.590,95%CI = 2.241 ~ 364.734;P = 0.010)、外伤性蛛网膜下隙出血(OR = 8.244,95%CI = 1.259 ~ 53.706;P =0.028)和颅内血肿(OR = 24.344,95%CI = 2.415 ~ 345.395;P = 0.007)为危险因素,且以脑挫裂伤危险度相对较高;而与颅脑创伤分型、损伤部位及凹陷性骨折无关。结论 开放性颅脑创伤后早期癫痫发作应及时治疗,对合并危险因素的患者应早期给予预防性抗癫痫药物治疗。
关键词:
脑损伤,
癫痫,
创伤后,
危险因素,
回归分析
Abstract: Objective To explore the risk factors for early post-traumatic seizure (EPTS) in opening traumatic brain injury (TBI), and to propose prophylaxis of the seizures. Methods Ninety-one patients were identified in Shanghai Institute of Neurosurgery from September 2006 to September 2009. Information were obtained on opening TBI and early post-traumatic seizure from these patients. The clinical data were analysed retrospectively. Results Chi?square test showed that age (χ2 = 5.131, P = 0.023), severity of injury (χ2 = 6.302, P = 0.043), site of lesion (χ2 = 12.800, P = 0.046), contusion (χ2 = 7.187, P = 0.007), traumatic subarachnoid hemorrhage (χ2 = 11.092, P = 0.001), intracerebral hematoma (χ2 = 6.555, P = 0.010) and depressed fracture (χ2 = 8.463, P = 0.043) were all significantly correlated with early post-traumatic seizure in opening TBI. Logistic regression analysis revealed that risk factors for early post-traumatic seizure were age (OR = 7.719, 95%CI = 1.129-52.777; P = 0.037), contusion (OR = 28.590, 95%CI = 2.241-364.734; P = 0.010), traumatic subarachnoid hemorrhage (OR = 8.244, 95%CI = 1.129-53.706; P = 0.028) and intracerebral hematoma (OR = 24.344, 95% CI = 2.415-345.395; P = 0.007). Conclusion Early post-traumatic seizure should be controlled promptly in patients with opening TBI, and anti-epileptic drugs should be used prophylactically on the patients with high risk factors.
Key words:
Brain injuries,
Epilepsy, post-traumatic,
Risk factors,
Regression analysis
张磊,于明琨,卢亦成,吴小军,陈怀瑞. 开放性颅脑创伤早期癫痫发作危险因素分析[J]. 中国现代神经疾病杂志, 2011, 11(3): 330-333.
ZHANG Lei, YU Mingkun, LU Yicheng, WU Xiaojun, CHEN Huairui. Analysis of risk factors related to early post-traumatic seizure in opening traumatic brain injury[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2011, 11(3): 330-333.