CAJ | 학술논문

目的探讨颅脑损伤继发创伤性脑梗死(TCI)的临床特点及其相关危险因素.方法选取480例颅脑损伤患者为研究对象,根据是否发生TCI将患者分为TCI组及非TCI组,观察TCI组患者临床症状、体征,分析其相关危险因素.结果 480例患者中,30例发生TCI,发生率为6.25%.临床表现包括偏侧肢体运动及感觉功能障碍,视觉功能异常,语言功能异常,头晕头痛.预后良好10例,轻度残疾6例,重度残疾3例,植物生存1例,死亡10例.单因素分析显示TCI组患者年龄≥50岁、GCS评分＜8分、存在脑疝、存在低血压、伴有蛛网膜下腔出血、应用大剂量脱水剂的比例高于非TCI组,差异均有统计学意义(x2=12.311 3、14.725 4、19.867 8、5.296 9、9.242 6、11.713 6,均P＜0.05).Logistic多因素分析显示,年龄≥50岁、GCS评分＜8分、存在脑疝、存在低血压为颅脑损伤继发TCI重要危险因素.结论颅脑损伤继发TCI患者临床表现具有一定特点,年龄≥50岁、GCS评分＜8分、存在脑疝、存在低血压为颅脑损伤继发脑梗死重要危险因素.
목적 탐토로뇌손상계발창상성뇌경사(TCI)적림상특점급기상관위험인소.방법 선취480례로뇌손상환자위연구대상,근거시부발생TCI장환자분위TCI조급비TCI조,관찰TCI조환자림상증상、체정,분석기상관위험인소.결과 480례환자중,30례발생TCI,발생솔위6.25%.림상표현포괄편측지체운동급감각공능장애,시각공능이상,어언공능이상,두훈두통.예후량호10례,경도잔질6례,중도잔질3례,식물생존1례,사망10례.단인소분석현시TCI조환자년령≥50세、GCS평분＜8분、존재뇌산、존재저혈압、반유주망막하강출혈、응용대제량탈수제적비례고우비TCI조,차이균유통계학의의(x2=12.311 3、14.725 4、19.867 8、5.296 9、9.242 6、11.713 6,균P＜0.05).Logistic다인소분석현시,년령≥50세、GCS평분＜8분、존재뇌산、존재저혈압위로뇌손상계발TCI중요위험인소.결론 로뇌손상계발TCI환자림상표현구유일정특점,년령≥50세、GCS평분＜8분、존재뇌산、존재저혈압위로뇌손상계발뇌경사중요위험인소.
Objective To investigate the clinical characteristics and related risk factors of infarction secondary to severe traumatic brain injury.Methods 480 traumatic brain injury patients were chosen.Depending on the occurrence of cerebral infarction,patients were divided into TCI groups and non-TCI group,clinical symptoms and signs of TCI group were observed,and its related risk factors was analyzed.Results In 480 cases patients,there were 30 cases of patients with traumatic brain injury secondary to cerebral infarction,the rate was 6.25%.Clinical manifestations included unilateral limb motor and sensory dysfunction,visual dysfunction,language dysfunction,dizziness,headache.10 cases Prognosis were good,6 cases were mild disability,3 cases were severe disability,1 case was plant survival,10 patients died.Univariate analysis showed that the rates of aged ≥50 years,GCS score ＜ 8 points,hernia,hypotension,subarachnoid hemorrhage,large doses of non-dehydrating agent in the TCI group were higher than those of non-TCI group,the differences were statistically significant (x2 =12.311 3,14.725 4,19.867 8,5.296 9,9.242 6,11.713 6,all P ＜ 0.05).Logistic multivariate analysis showed that age ≥50 years,GCS score ＜ 8 points,hernia,cerebral hypotension were important risk factors.Conclusion Brain injury patients with cerebral infarction secondary to clinical manifestations have some characteristics.Age ≥50 years,GCS score ＜ 8 points,hernia,hypotension are important risk factors.