论文部分内容阅读
目的探讨轻度脑外伤早期病情恶化进展的影响因素。方法 413例轻度颅脑外伤患者依据病情是否进展分为病情进展组21例与病情未进展组392例,比较2组一般资料,采用单因素及多因素logistic回归模型分析轻度颅脑外伤患者早期病情进展恶化的影响因素。结果 2组患者性别比例及伤后镇静药使用情况比较差异无统计学意义(P>0.05);非条件单因素logistic回归模型分析显示,年龄≥60岁、一过性意识丧失、中线移位>0.5cm、脑挫裂伤或颅内血肿、GCS评分、神经功能缺失、高血压、使用抗凝药是病情恶化进展的影响因素;多因素logistic回归分析显示,年龄≥60岁、中线移位>0.5cm、脑挫伤或颅内血肿、使用抗凝药是轻度颅脑外伤患者早期病情进展恶化的独立危险因素。结论对年龄≥60岁、中线移位>0.5cm、脑挫伤或颅内血肿、使用抗凝药的颅脑外伤患者进行早期干预,对预防病情进展及改善预后有重要意义。
Objective To investigate the influencing factors of the progression of mild brain injury in early stage. Methods A total of 413 mild craniocerebral trauma patients were divided into two groups according to whether the disease progressed or not. Twenty-one patients were divided into progressive disease group and 392 non-progressive disease group. The general data of two groups were compared. One-factor and multivariate logistic regression models were used to analyze the patients with mild craniocerebral trauma Factors affecting the progression of early disease. Results There was no significant difference in the sex ratio and the use of sedatives after injury between the two groups (P> 0.05). Unconditional univariate logistic regression analysis showed that when the age was over 60 years, the transient loss of consciousness, median shift> 0.5cm, cerebral contusion or intracranial hematoma, GCS score, neurological deficit, hypertension, the use of anticoagulants is the progression of the disease progression factors; multivariate logistic regression analysis showed that age ≥ 60 years, median shift> 0.5cm, cerebral contusion or intracranial hematoma, the use of anticoagulants in patients with mild craniocerebral injury was an independent risk factor for early deterioration. Conclusion Early intervention in patients with craniocerebral trauma of age ≥60 years, midline displacement> 0.5cm, cerebral contusion or intracranial hematoma and anticoagulant therapy is of great significance in preventing the progression of the disease and improving the prognosis.