中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
6期
7-9
,共3页
张牧城%汪健蕾%汪正光%程金霞%郑绍鹏%姚建华%方向群
張牧城%汪健蕾%汪正光%程金霞%鄭紹鵬%姚建華%方嚮群
장목성%왕건뢰%왕정광%정금하%정소붕%요건화%방향군
重度颅脑损伤%外伤性脑梗死%危险因素
重度顱腦損傷%外傷性腦梗死%危險因素
중도로뇌손상%외상성뇌경사%위험인소
Severe craniocerebral trauma%Traumatic cerebral infarction%Risk factors
目的 探讨重度颅脑损伤继发外伤性脑梗死(traumatic cerebral infarction,TCI)的危险因素.方法 对126例重度颅脑损伤及合并伤患者就发生TCI进行单因素和多因素Logistic回归分析.结果 继发TCI 47例,脑梗死组与非梗死组在低血压、脑挫裂伤、蛛网膜下腔出血、脑疝、低血压时间、脑疝时间、糖尿病(或血糖≥11.1 mol/L持续24 h以上)、伤后或术后机械通气<48 h比较差异均有显著性(P<0.05),以上8因素均是发生TCI的重要危险因素;Logistic回归分析显示脑挫裂伤、伤后或术后机械通气<48 h、低血压时间、脑疝时间是发生TCI的独立危险因素.结论 脑挫裂伤、伤后或术后机械通气<48 h、低血压时间、脑疝时间、低血压、蛛网膜下腔出血、脑疝、糖尿病(或血糖≥11.1 mol/L持续24 h)是重度颅脑损伤继发TCI的危险因素,其中脑挫裂伤、伤后或术后机械通气<48 h、低血压时间、脑疝时间是独立危险因素.
目的 探討重度顱腦損傷繼髮外傷性腦梗死(traumatic cerebral infarction,TCI)的危險因素.方法 對126例重度顱腦損傷及閤併傷患者就髮生TCI進行單因素和多因素Logistic迴歸分析.結果 繼髮TCI 47例,腦梗死組與非梗死組在低血壓、腦挫裂傷、蛛網膜下腔齣血、腦疝、低血壓時間、腦疝時間、糖尿病(或血糖≥11.1 mol/L持續24 h以上)、傷後或術後機械通氣<48 h比較差異均有顯著性(P<0.05),以上8因素均是髮生TCI的重要危險因素;Logistic迴歸分析顯示腦挫裂傷、傷後或術後機械通氣<48 h、低血壓時間、腦疝時間是髮生TCI的獨立危險因素.結論 腦挫裂傷、傷後或術後機械通氣<48 h、低血壓時間、腦疝時間、低血壓、蛛網膜下腔齣血、腦疝、糖尿病(或血糖≥11.1 mol/L持續24 h)是重度顱腦損傷繼髮TCI的危險因素,其中腦挫裂傷、傷後或術後機械通氣<48 h、低血壓時間、腦疝時間是獨立危險因素.
목적 탐토중도로뇌손상계발외상성뇌경사(traumatic cerebral infarction,TCI)적위험인소.방법 대126례중도로뇌손상급합병상환자취발생TCI진행단인소화다인소Logistic회귀분석.결과 계발TCI 47례,뇌경사조여비경사조재저혈압、뇌좌렬상、주망막하강출혈、뇌산、저혈압시간、뇌산시간、당뇨병(혹혈당≥11.1 mol/L지속24 h이상)、상후혹술후궤계통기<48 h비교차이균유현저성(P<0.05),이상8인소균시발생TCI적중요위험인소;Logistic회귀분석현시뇌좌렬상、상후혹술후궤계통기<48 h、저혈압시간、뇌산시간시발생TCI적독립위험인소.결론 뇌좌렬상、상후혹술후궤계통기<48 h、저혈압시간、뇌산시간、저혈압、주망막하강출혈、뇌산、당뇨병(혹혈당≥11.1 mol/L지속24 h)시중도로뇌손상계발TCI적위험인소,기중뇌좌렬상、상후혹술후궤계통기<48 h、저혈압시간、뇌산시간시독립위험인소.
Objective To find out risk factors of traumatic cerebral infarction(TCI). Methods 126 cases in severe craniocerebral trauma were analyzed, risk factors of TCI were screened by single factor and Logis-tic regression analysis. Results TCI was found in 47 patients. There was significant difference on low blood pressure, contusion and laceration of brain, subarachnoid hemorrhage, brain herniation, duration of low blood pressure, duration of brain herniation, DM(or duration of blood glucose more than11.1 mmol/L≥24 h), dura-tion of mechanical ventilation after trauma or operation <48 h between TCI group and non-TCI group (P<0.05), Logistic regression analysis of them indicated that contusion and laceration of brain, duration of mechani-cal ventilation after trauma or operation <48 h, duration of low blood pressure, duration of brain hernia were in-dependent risk factors. Conclusion The contusion and laceration of brain, duration of mechanical ventilation after trauma or operation <48 h,low blood pressure and its duration, brain herniation and its duration, subarach-noid hemorrhage, DM (or duration of blood glucose more than11.1 mmol/L≥24 h)were the risk factors of TCI, and the contusion and laceration of brain, duration of mechanical ventilation after trauma or operation <48 h, du-ration of low blood pressure, duration of brain hernia were independent risk factors.
