CAJ | 학술논문

目的：探讨手术治疗重型颅脑损伤患者的生存状況及其影响因素。方法对我院收治的98例行去骨瓣减压术治疗的重型颅脑损伤患者的临床资料进行回顾性分析，根据术后扩展格拉斯哥预后评分(GOSE)分为预后良好组58例与预后不良组40例，对比两组的临床特点，并对预后因素进行单因素及多因素分析。结果两组患者年龄、入院瞳孔直径、受伤至手术时间、入院GCS评分及CT值等比较差异均有统计学意义(P<0.05)；多因素回归分析显示，年龄、入院瞳孔直径、受伤至手术时间、入院GCS评分及CT值等是患者预后的显著影响因素(P<0.05)；预后良好组的术后并发症发生率显著低于预后不良组，差异有统计学意义(P<0.05)。结论行手术治疗的重型颅脑损伤患者的生存状况较差，与年龄、入院瞳孔直径、受伤至手术时间、入院GCS评分及CT值等因素密切相关，应引起临床重视。
목적：탐토수술치료중형로뇌손상환자적생존상황급기영향인소。방법대아원수치적98례행거골판감압술치료적중형로뇌손상환자적림상자료진행회고성분석，근거술후확전격랍사가예후평분(GOSE)분위예후량호조58례여예후불량조40례，대비량조적림상특점，병대예후인소진행단인소급다인소분석。결과량조환자년령、입원동공직경、수상지수술시간、입원GCS평분급CT치등비교차이균유통계학의의(P<0.05)；다인소회귀분석현시，년령、입원동공직경、수상지수술시간、입원GCS평분급CT치등시환자예후적현저영향인소(P<0.05)；예후량호조적술후병발증발생솔현저저우예후불량조，차이유통계학의의(P<0.05)。결론행수술치료적중형로뇌손상환자적생존상황교차，여년령、입원동공직경、수상지수술시간、입원GCS평분급CT치등인소밀절상관，응인기림상중시。
Objective To investigate the living conditions and its influence factors of patients with severe craniocerebral injury undergoing operative treatment. Methods The clinical data of 98 patients with severe cranioce-rebral injury who were treated by decompressive craniectomy in our hospital were analyzed retrospectively. All the pa-tients were divided into good prognosis group (58 cases) and poor prognosis group (40 cases) according to the postop-erative extension Glasgow outcome score (GOSE). The clinical characteristics of two groups were compared, and its influence factors were analyzed by univariate and multivariate logistic regression analysis. Results The difference in age, pupil diameter of admission, time interval from injury, GCS scores and CT number between the two groups were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that age, pupil diameter of admis-sion, time interval from injury, GCS scores and CT number were all the remarkable influence factors of the prognosis (P<0.05). The postoperative complication rate of good prognosis group was significantly lower than that of poor prog-nosis group, and the difference was statistically significant (P<0.05). Conclusion The living conditions of patients with severe craniocerebral injury treated by operative treatment is poor, which is related to age, pupil diameter of ad-mission, time interval from injury, GCS scores and CT number closely, and close attention should be paid to it in clini-cal practice.