CAJ | 학술논문

目的探讨重型创伤性颅脑损伤去骨瓣减压术患者的预后相关因素.方法回顾性分析北京军区总医院附属八一脑科医院自2011年1月至2012年6月收治的共61例重型颅脑损伤患者的临床资料,研究年龄、受伤-手术时间间隔、入院GCS评分、瞳孔直径、CT值等因素对患者预后的影响,预后以6个月内的扩展的Glasgow预后量表(GOSE)评分判断.结果单因素分析表明,年龄[(39.11±14.42)岁vs(53.93±14.64)岁]、受伤-手术时间间隔[(35.66±47.69)h vs(9.54±12.18)h]、瞳孔直径[左侧:(3.03±0.72) mm vs(3.52±1.04) mm;右侧:(2.83±0.51) mm vs(3.56±1.00)mm]、入院GCS评分[(6.39±1.54)分vs(4.52±1.10)分]、CT值(3.53±0.91 vs 4.50±0.97)在预后良好和预后不良组间比较差异均有统计学意义(P＜0.05).多因素Logistic回归分析表明,年龄、受伤-手术时间间隔、瞳孔直径、人院GCS评分、CT值都与预后密切相关(OR=0.166,95 ％CI:0.029～0.821,P=0.031;OR=0.124,95％CI:0.024～0.661,P=0.015;OR=0.024,95％CI:0.015～0.374,P=0.034;OR=0.131,95％CI:0.045～0.433,P=0.011;OR=0.059,95％CI:0.014～0.323,P=0.012).结论年龄、受伤-手术时间间隔、入院GCS评分、瞳孔变化和术前头颅CT影像学表现均可作为评价颅脑损伤预后的临床指标.
목적 탐토중형창상성로뇌손상거골판감압술환자적예후상관인소.방법 회고성분석북경군구총의원부속팔일뇌과의원자2011년1월지2012년6월수치적공61례중형로뇌손상환자적림상자료,연구년령、수상-수술시간간격、입원GCS평분、동공직경、CT치등인소대환자예후적영향,예후이6개월내적확전적Glasgow예후량표(GOSE)평분판단.결과 단인소분석표명,년령[(39.11±14.42)세vs(53.93±14.64)세]、수상-수술시간간격[(35.66±47.69)h vs(9.54±12.18)h]、동공직경[좌측:(3.03±0.72) mm vs(3.52±1.04) mm;우측:(2.83±0.51) mm vs(3.56±1.00)mm]、입원GCS평분[(6.39±1.54)분vs(4.52±1.10)분]、CT치(3.53±0.91 vs 4.50±0.97)재예후량호화예후불량조간비교차이균유통계학의의(P＜0.05).다인소Logistic회귀분석표명,년령、수상-수술시간간격、동공직경、인원GCS평분、CT치도여예후밀절상관(OR=0.166,95 ％CI:0.029～0.821,P=0.031;OR=0.124,95％CI:0.024～0.661,P=0.015;OR=0.024,95％CI:0.015～0.374,P=0.034;OR=0.131,95％CI:0.045～0.433,P=0.011;OR=0.059,95％CI:0.014～0.323,P=0.012).결론 년령、수상-수술시간간격、입원GCS평분、동공변화화술전두로CT영상학표현균가작위평개로뇌손상예후적림상지표.
Objective To explore the outcome related factors of patients with severe traumatic brain injury (TBI) following craniectomy.Methods Sixty-one TBI patients,admitted to and underwent craniectomy in our hospital from January 2011 to June 2012,were selected.The influences of such factors of these patients as age,interval of injury to operation,Glasgow coma scale (GCS) scores at admission,pupil diameter and CT values in outcomes of the patients were evaluated.The prognosis was evaluated according to extensional Glasgow Outcome Scale (GOSE).Results Single factor analysis showed that mean age (39.11±14.42 years vs.53.93±14.64 years),interval of injury to operation [(35.66±47.69) h vs.(9.54±12.18) h],pupil diameters [left:(3.03±0.72) mm vs.(3.52±1.04) mm; right:(2.83± 0.51) mm vs.(3.56±1.00) mm],GCS scores at admission [6.39±1.54 vs.4.52±1.10] and CT value (3.53±0.91 vs.4.50±0.97) were significantly different between patients with good prognosis and poor prognosis (P＜0.05).Multivariate Logistic regression analysis showed that age,interval of injury to operation,GCS scores at admission,pupil diameter and CT values were closely related to the prognosis (OR=0.166,95％ CI:0.029-0.821,P=0.031; OR=0.124,95％CI:0.024-0.661,P=0.015; OR=0.024,95％CI:0.015-0.374,P=0.034; OR=0.131,95％CI:0.045-0.433,P=0.011; OR=0.059,95％CI:0.014-0.323,P=0.012).Conclusion Age,interval of injury to operation,Glasgow coma scale (GCS) scores at admission,pupil diameter and CT values could be generally applied as indicators to assess the outcome of TBI patients.