CAJ | 학술논문

目的探讨重型颅脑损伤患者自主神经功能紊乱综合征发生率、临床症状、发病危险因素及预后.方法回顾性分析2008年1月-2010年3月收治的142例重型颅脑损伤患者,比较自主神经功能障碍组和对照组(无自主神经功能障碍患者)的临床特征;采用Logistic回归分析自主神经功能障碍发病的危险因素;伤后6个月采用GOS评分分析其预后.结果142例患者中生存并成功随访94例,自主神经功能障碍患者16例(17%),且其在GCS评分、昏迷时间、ICU时间、平均住院时间等方面较对照组差异有统计学意义(P<0.05);自主神经功能障碍患者预后较差(P<0.05),与弥漫性轴索损伤(DAI)密切相关(OR=11.25,95%CI 7.65～16.54).结论自主神经功能障碍在严重颅脑损伤患者中发生率较高,临床表现重,DAI增加其发作风险,此类患者多预后不良.
목적 탐토중형로뇌손상환자자주신경공능문란종합정발생솔、림상증상、발병위험인소급예후.방법회고성분석2008년1월-2010년3월수치적142례중형로뇌손상환자,비교자주신경공능장애조화대조조(무자주신경공능장애환자)적림상특정;채용Logistic회귀분석자주신경공능장애발병적위험인소;상후6개월채용GOS평분분석기예후.결과142례환자중생존병성공수방94례,자주신경공능장애환자16례(17%),차기재GCS평분、혼미시간、ICU시간、평균주원시간등방면교대조조차이유통계학의의(P<0.05);자주신경공능장애환자예후교차(P<0.05),여미만성축색손상(DAI)밀절상관(OR=11.25,95%CI 7.65～16.54).결론 자주신경공능장애재엄중로뇌손상환자중발생솔교고,림상표현중,DAI증가기발작풍험,차류환자다예후불량.
Objective To investigate the incidence, clinical symptoms, correlative risk factors and prognosis of dysautonomia in patients with severe traumatic brain injury. Methods A total of 142patients with severe traumatic brain injury treated from January 2008 to March 2010 were retrospectively surveyed to compare the clinical features of dysautonomia group and control group. Logistic regression was used to analyze the risk factors for dysautonomia. At 6 months post-trauma, the Glasgow Outcome Score (GOS) was used to measure the outcome. Results Of all the patients, 94 patients survived and were followed up. There were 16 patients ( 17% ) diagnosed as dysautonomia depended on clinical symptoms,with statistical difference in aspects of GCS, coma duration, ICU time and average length of stay (ALOS)(P < 0.05). The patients with dysautonomia tended to have poorer outcome ( P < 0.05 ) and showed a positive association with diffuse axonal injury (DAI) ( OR = 11. 25, CI 7.65-16.54 ). Conclusion Dysautonomia has high incidence and is usually severe in patients with severe traumatic brain injury,when DAI may contribute to its occurrence and result in poor prognosis.