[1]冯勇,郭伟,王晓宏.2岁以下婴儿非交通事故性轻型颅脑损伤发生颅内异常的危险因素分析[J].中国临床神经外科杂志,2023,28(06):375-377382.[doi:10.13798/j.issn.1009-153X.2023.06.007]
　Feng Yong,Guo Wei,Wang Xiao-hong.Risk factors for intracranial abnormalities of infants under 2 years old with mild traumatic brain injury due to causes other than traffic accidents[J].,2023,28(06):375-377382.[doi:10.13798/j.issn.1009-153X.2023.06.007]
点击复制

2岁以下婴儿非交通事故性轻型颅脑损伤发生颅内异常的危险因素分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年06期
页码:
375-377382
栏目:
论著
出版日期:
2023-06-30

文章信息/Info

Title:
Risk factors for intracranial abnormalities of infants under 2 years old with mild traumatic brain injury due to causes other than traffic accidents
文章编号:
1009-153X（2023）06-0375-03
作者:
冯勇; 郭伟; 王晓宏
741000甘肃，天水市中西医结合医院神经外科（冯勇、郭伟、王晓宏）
Author(s):
Feng Yong;  Guo Wei;  Wang Xiao-hong
Department of Neurosurgery, Tianshui Hospital of Integrated Chinese and Western Medicine, Tianshui 741000, China
关键词:
轻型颅脑损伤; 婴儿; 非交通事故; 颅内异常; 危险因素
Keywords:
Mild traumatic brain injury;  Infants;  Children;  Non-traffic accident;  Intracranial abnormalities;  Risk factor
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2023.06.007
文献标志码:
R 651.1+5
摘要:
目的 探讨2岁以下婴儿非交通事故性轻型颅脑损伤发生颅内异常的危险因素。方法 回顾性分析2018年1月至2021年12月收治的258例2岁以下婴儿非交通事故性轻型颅脑损伤的临床资料。根据初次CT检查判断颅内异常情况。结果 258例中，初次CT检查发生颅内异常32例，发生率为12.4%。单因素分析显示头皮血肿大小及部位与颅内异常有关（P<0.05）。多因素logistic回归分析示，颞部头皮血肿（OR=23.767；95% CI 2.843~198.664；P=0.003）、头皮血肿直径>3 cm（OR=25.807；95% CI 3.261~204.261；P=0.002）是2岁以内婴儿非交通事故性轻型颅脑损伤发生颅内异常的独立危险因素。结论 对2岁以下婴儿非交通事故性轻型颅脑损伤，颞部头皮血肿和血肿大小可以帮助预测颅内异常。这提示头皮包块的大小及部位可指导临床决策，减少婴儿CT检查，从而减少辐射暴露。
Abstract:
Objective To investigate the risk factors for intracranial abnormalities of infants under 2 years old with mild traumatic brain injury (mTBI) due to causes other than traffic accidents. Methods The clinical data of 258 infants under 2 years of age with mTBI due to causes other than traffic accidents who were admitted to our hospital from January 2018 to December 2021 were retrospectively analyzed. The intracranial abnormalities were determined by the initial CT examination. Results Of 258 cases, 32 cases (12.4%) had intracranial abnormalities on initial CT examination. Univariate analysis showed that scalp hematoma, scalp hematoma size and scalp hematoma location were related to the intracranial abnormalities (P<0.05). Multivariate logistic regression analysis showed that temporal scalp hematoma (OR=23.767; 95% CI 2.843~198.664; P=0.003) and scalp hematoma diameter >3 cm (OR=25.807; 95% CI 3.261~204.261; P=0.002) were independent risk factors for intracranial abnormalities of infants with mTBI due to causes other than traffic accidents. Conclusions The temporal scalp hematoma and hematoma size can help to predict the intracranial abnormalities of infants under 2 years of age with mTBI due to causes other than traffic accidents. Our results suggest that the size and location of the scalp mass can guide clinical decision making, reduce CT examination, and thus reduce radiation exposure in infants.

参考文献/References:

[1]Yengo-Kahn AM, Reynolds RA, Bonfield CM. Mild traumatic brain injury in children [J]. Pediatr Clin N Am, 2021, 68(4): 857-874.
[2]申汉威，李俊卿，李红星，等. 小儿颅脑损伤的临床特点及治疗分析[J]. 中国临床神经外科杂志，2015，20（4）：231-232.
[3]Mccormick BF, Connolly EJ, Nelson DV. Mild traumatic brain injury as a predictor of classes of youth internalizing and externalizing psychopathology [J]. Child Psychiatry Hum Dev, 2021, 52(1): 166-178.
[4]Shahi V, Brinjikji W, Cloft H J, et al. Trends in CT utilization for pediatric fall patients in US emergency departments [J]. Acad Radiol, 2015, 22(7): 898-903.
[5]Zhu H, Gao Q, Xia X, et al. Clinically-important brain injury and CT findings in pediatric mild traumatic brain injuries: a prospective study in a Chinese reference hospital [J]. Int J Environ Res Public Health, 2014, 11(4): 3493-506.
[6]Miglioretti DL, Johnson E, Williams A, et al. The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk [J]. Jama Pediatr, 2013, 167(8): 700-707.
[7]Carroll L, Cassidy JD, Holm L, et al. Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury [J]. J Rehabil Med, 2004, 36(43 Suppl): 113-125.
[8]中华医学会神经外科学分会颅脑创伤专业组，中华医学会创伤学分会神经损伤专业组. 儿童颅脑创伤诊治中国专家共识[J]. 中华神经外科杂志，2021，37（12）：1200-1208.
[9]Ohbuchi H, Hagiwara S, Hirota K, et al. Clinical predictors of intracranial injuries in infants with minor head trauma [J]. World Neurosurg, 2017, 98: 479-483.
[10]Andrade FP, Montoro R, Oliveira R, et al. Pediatric minor head trauma: do cranial CT scans change the therapeutic approach [J]. Clinics, 2016, 71(10): 606-610.
[11]Dayan PS, Holmes JF, Atabaki S, et al. Association of trau-matic brain injuries with vomiting in children with blunt head trauma [J]. Ann Emerg Med, 2014, 63(6): 657-665.
[12]Huisman TA. CT should not be relied on for cases of isolated vomiting in children with blunt head trauma [J]. Evid Based Med, 2015, 20(1): 32.
[13]狄广福，方新运，邵学非，等. 儿童轻型颅脑损伤中头颅CT异常患者的危险因素[J]. 临床与病理杂志，2020，40（1）：75-79.
[14]Ohbuchi H, Hagiwara S, Hirota K, et al. Clinical predictors of intracranial injuries in infants with minor head trauma [J]. World Neurosurg, 2017, 98: 479-483.

相似文献/References:

[1]娄元华　李小勇　陈红伟　潘栋超　解东成　刘东升.婴儿脑积水分流术后硬膜下积液的临床分析[J].中国临床神经外科杂志,2016,(04):245.[doi:10.13798/j.issn.1009-153X.2016.04.019]
[2]陈文杰　陈龙钦　叶金练　吴文彬　王守森　荆俊杰　赵清爽　陈业煌.晚发型维生素K1缺乏症致颅内出血34例临床治疗体会[J].中国临床神经外科杂志,2018,(02):109.
[3]林　靖　张　炜　郑小强　程宏伟　高瑞庭　宋朝理.大鼠轻型颅脑损伤后星形胶质细胞与神经元的病理改变[J].中国临床神经外科杂志,2018,(04):246.[doi:10.13798/j.issn.1009-153X.2018.04.008]
　LIN Jing,ZHANG Wei,ZHENG Xiao-qiang,et al.Pathological changes in astrocytes and neurons after mild traumatic brain injury in rats[J].,2018,(06):246.[doi:10.13798/j.issn.1009-153X.2018.04.008]
[4]马生辉　王铄辰　陈奥博等.轻型颅脑损伤病人认知功能障碍的研究进展[J].中国临床神经外科杂志,2021,26(12):956.[doi:10.13798/j.issn.1009-153X.2021.12.021]

备注/Memo

备注/Memo:
（2022-10-22收稿，2023-01-27修回）
更新日期/Last Update: 2022-06-30