中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2011年
10期
613-615
,共3页
颅脑损伤,轻型%颅脑CT%危险因素%Logistic回归分析
顱腦損傷,輕型%顱腦CT%危險因素%Logistic迴歸分析
로뇌손상,경형%로뇌CT%위험인소%Logistic회귀분석
Mild head injury%Brain computerized tomography%Risk factor%Logistic regression analysis
目的 探讨轻型颅脑损伤(MHI)患者的危险因素,为临床判断MHI程度提供参考依据.方法 回顾性分析4 884例MHI患者的临床各因素和颅脑CT检查结果,对患者的性别、年龄(≥65岁、＜65岁)、意识丧失、逆行性健忘、呕吐、脑脊液漏、癫痫、头皮外伤、神经病学阳性体征和格拉斯哥昏迷评分(GCS)进行非条件Logistic回归分析.结果 Logistic回归分析显示,性别优势比(OR)=0.703,95%可信区间(95%CI)0.530.94,P=0.02;年龄≥65岁OR=3.74,95%CI 2.38～5.88,P=0.00;意识丧失OR=18.17,95%CI 12.66～26.07,P=0.00；逆行性健忘OR=4.19,95%CI 2.17～8.07,P=0.00；呕吐OR=27.01,95 %CI 18.45～39.55,P=0.00；脑脊液漏OR=63.80,95%CI 33.01～123.30,P=0.00；癫痫OR=1.61,95 %CI 0.30～8.58,P=0.58；头皮外伤OR=0.95,95%CI 0.75～1.22,P=0.69;神经病学阳性体征OR= 9.87,95%CI 2.03～47.95,P=0.05；GCS评分OR=1.10,95 %CI 0.85～1.42,P=0.47,其中男性、高龄(≥65岁)、意识丧失、逆行性健忘、呕吐、脑脊液漏、神经病学阳性体征是MHI的危险因素.结论 性别、年龄、意识丧失、逆行性健忘、呕吐、脑脊液漏、神经病学阳性体征对判断MHI程度有一定意义,可为临床处理这类损伤提供有益的参考依据.
目的 探討輕型顱腦損傷(MHI)患者的危險因素,為臨床判斷MHI程度提供參攷依據.方法 迴顧性分析4 884例MHI患者的臨床各因素和顱腦CT檢查結果,對患者的性彆、年齡(≥65歲、＜65歲)、意識喪失、逆行性健忘、嘔吐、腦脊液漏、癲癇、頭皮外傷、神經病學暘性體徵和格拉斯哥昏迷評分(GCS)進行非條件Logistic迴歸分析.結果 Logistic迴歸分析顯示,性彆優勢比(OR)=0.703,95%可信區間(95%CI)0.530.94,P=0.02;年齡≥65歲OR=3.74,95%CI 2.38～5.88,P=0.00;意識喪失OR=18.17,95%CI 12.66～26.07,P=0.00；逆行性健忘OR=4.19,95%CI 2.17～8.07,P=0.00；嘔吐OR=27.01,95 %CI 18.45～39.55,P=0.00；腦脊液漏OR=63.80,95%CI 33.01～123.30,P=0.00；癲癇OR=1.61,95 %CI 0.30～8.58,P=0.58；頭皮外傷OR=0.95,95%CI 0.75～1.22,P=0.69;神經病學暘性體徵OR= 9.87,95%CI 2.03～47.95,P=0.05；GCS評分OR=1.10,95 %CI 0.85～1.42,P=0.47,其中男性、高齡(≥65歲)、意識喪失、逆行性健忘、嘔吐、腦脊液漏、神經病學暘性體徵是MHI的危險因素.結論 性彆、年齡、意識喪失、逆行性健忘、嘔吐、腦脊液漏、神經病學暘性體徵對判斷MHI程度有一定意義,可為臨床處理這類損傷提供有益的參攷依據.
목적 탐토경형로뇌손상(MHI)환자적위험인소,위림상판단MHI정도제공삼고의거.방법 회고성분석4 884례MHI환자적림상각인소화로뇌CT검사결과,대환자적성별、년령(≥65세、＜65세)、의식상실、역행성건망、구토、뇌척액루、전간、두피외상、신경병학양성체정화격랍사가혼미평분(GCS)진행비조건Logistic회귀분석.결과 Logistic회귀분석현시,성별우세비(OR)=0.703,95%가신구간(95%CI)0.530.94,P=0.02;년령≥65세OR=3.74,95%CI 2.38～5.88,P=0.00;의식상실OR=18.17,95%CI 12.66～26.07,P=0.00；역행성건망OR=4.19,95%CI 2.17～8.07,P=0.00；구토OR=27.01,95 %CI 18.45～39.55,P=0.00；뇌척액루OR=63.80,95%CI 33.01～123.30,P=0.00；전간OR=1.61,95 %CI 0.30～8.58,P=0.58；두피외상OR=0.95,95%CI 0.75～1.22,P=0.69;신경병학양성체정OR= 9.87,95%CI 2.03～47.95,P=0.05；GCS평분OR=1.10,95 %CI 0.85～1.42,P=0.47,기중남성、고령(≥65세)、의식상실、역행성건망、구토、뇌척액루、신경병학양성체정시MHI적위험인소.결론 성별、년령、의식상실、역행성건망、구토、뇌척액루、신경병학양성체정대판단MHI정도유일정의의,가위림상처리저류손상제공유익적삼고의거.
Objective To identify the risk factors in patients with MHI for the evaluation of the severity of the damage.Methods The clinical data and brain CT findings from 4 884 MHI patients were analyzed retrospectively using non-conditional Logistic regression for their relation to gender,age (≥≥65 years,< 65 years),loss of consciousness,retrograde amnesia,vomiting,cerebrospinal fluid-otorrhea/rhinorrhea,epilepsy,scalp trauma,positive neurological signs and glasgow coma scale (GCS).Results The odds ratio (OR),95% confidence interval (95% CI),and confidence coefficient (P) for all the factors were demonstrated as follows,repectively,gender:(0.703,0.53 ~ 0.94,0.02); age》 65 years:( 3.74,2.38 - 5.88,0.00); loss of consciousness:(18.17,12.66 - 26.07,0.00); retrograde amnesia:( 4.19,2.17 - 8.07,0.00); vomiting:( 27.01,18.45 ~ 39.55,0.00); cerebrospinal fluid-otorrhea/thinorrhea:(63.80,33.01 - 123.30,0.00); epilepsy:(1.61,0.30 ~ 8.58,0.58); scalp trauma:(0.95,0.75 - 1.22,0.69); positive neurological signs:(9.87,2.03 - 47.95,0.05); and GCS score:(1.10,0.85 - 1.42,0.47).The factor male,age≥65 years,loss of consciousness,retrograde forgetfulness,vomiting,cerebrospinal fluid-otorrhea/rhinorrhea,and positive neurological signs were found to be risk factors for MHl.Conclusion The risk factors as listed above may serve as indexes in the severity evaluation for MHI,and the design of treatment-plan for the patients.
