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目的探究颅脑损伤昏迷患者预后的影响因素。方法选取2012年4月—2013年6月抚州市第一人民医院收治的120例颅脑损伤昏迷患者,按照出院随访3个月后格拉斯哥昏迷量表(GCS)评分分为预后良好组100例(GCS评分>11分)和预后不良组20例(GCS评分≤11分)。分析患者的性别,年龄,受伤类型,心律失常、低血压、瞳孔散大、对光反射消失、消化道出血、肺部感染、高钠血症发生情况,入院时GCS评分,手术时间及血糖与其预后的关系。结果预后不良组患者年龄≥60岁者所占比例、低血压发生率、瞳孔散大发生率、对光反射消失发生率、消化道出血发生率、肺部感染发生率、高钠血症发生率、入院时GCS评分≤5分者所占比例、血糖高于预后良好组,手术时间长于预后良好组(P<0.05);两组患者性别、心律失常发生率及受伤类型比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,年龄≥60岁、低血压、瞳孔散大、对光反射消失、入院时GCS评分≤5分是颅脑损伤昏迷患者预后不良的独立危险因素(P<0.05)。结论年龄≥60岁、低血压、瞳孔散大、对光反射消失、入院时GCS评分≤5分是颅脑损伤昏迷患者预后不良的独立危险因素,临床上应密切观察该类患者的生命体征变化,及时对症治疗。
Objective To investigate the influencing factors of prognosis in patients with craniocerebral injury and coma. Methods A total of 120 patients with craniocerebral injury who were admitted to the First People’s Hospital of Fuzhou from April 2012 to June 2013 were selected and divided into three groups according to the Glasgow Coma Scale (GCS) GCS score> 11 points) and poor prognosis group (GCS score ≤11 points). Analysis of the patient’s gender, age, type of injury, arrhythmia, hypotension, dilated pupils, disappearance of light reflex, gastrointestinal bleeding, pulmonary infection, the incidence of hypernatremia, admission GCS score, operative time and blood glucose Prognosis of the relationship. Results The prognosis of patients with poor prognosis of patients ≥ 60 years of age, the incidence of hypotension, mydriasis, the incidence of light reflex, the incidence of gastrointestinal bleeding, the incidence of pulmonary infection, the incidence of hypernatremia , Admission GCS score ≤ 5 points in proportion, blood glucose higher than the good prognosis group, the operation time longer than the good prognosis group (P <0.05); two groups of patients with gender, arrhythmia incidence and type of injury, the difference was not statistically significant Significance (P> 0.05). Multivariate Logistic regression analysis showed that the age ≥ 60 years old, hypotension, dilated pupils, light reflex disappeared, admission GCS score ≤ 5 points is an independent risk factor for poor prognosis in patients with craniocerebral injury coma (P <0.05). Conclusion The age ≥ 60 years old, hypotension, mydriasis, light reflex, admission GCS score ≤ 5 points is an independent risk factor for poor prognosis in patients with craniocerebral injury coma, clinical changes should be closely observed in such patients , Timely symptomatic treatment.