[1]彭占威,赵恺,郭校,等.大面积脑梗死病人去骨瓣减压术治疗早期预后的影响因素分析[J].中国临床神经外科杂志,2023,28(07):444-447.[doi:10.13798/j.issn.1009-153X.2023.07.008]
 PENG Zhan-wei,ZHAO Kai,GUO Xiao,et al.Prognostic factors of patients with massive cerebral infarction undergoing decompressive craniectomy[J].,2023,28(07):444-447.[doi:10.13798/j.issn.1009-153X.2023.07.008]
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大面积脑梗死病人去骨瓣减压术治疗早期预后的影响因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年07期
页码:
444-447
栏目:
论著
出版日期:
2023-07-31

文章信息/Info

Title:
Prognostic factors of patients with massive cerebral infarction undergoing decompressive craniectomy
文章编号:
1009-153X(2023)07-0444-04
作者:
彭占威赵恺郭校欧一博
430030武汉,华中科技大学同济医学院附属同济医院神经外科(彭占威、赵恺、郭校、欧一博)
Author(s):
PENG Zhan-wei ZHAO Kai GUO Xiao OU Yi-bo
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
关键词:
大面积脑梗塞去骨瓣减压术预后影响因素
Keywords:
Massive cerebral infarction Decompressive craniectomy Prognosis Risk factors
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2023.07.008
文献标志码:
R743;R651.1+2
摘要:
目的 探讨去骨瓣减压术治疗的大面积脑梗塞出院时预后的影响因素。方法 回顾性分析2014~2021年去骨瓣减压术治疗的80例大面积脑梗塞的临床资料。出院时,采用GOS评分评估预后,其中4~5分为预后良好,1~3分为预后不良。结果 出院时,预后良好48例,预后不良32例。单因素分析显示脑梗塞部位、术前活化部分凝血活酶时间(APTT)、中线移位程度、术前瞳孔对光反射与出院时预后有关(P<0.05),多因素logistic回归分析显示,术前APTT延长(OR=1.994;95% CI 1.406~2.828;P<0.001)、中线移位≥10 mm(OR=5.793;95% CI 1.024~32.784;P=0.047)、术前瞳孔对光反射消失(OR=7.835;95% CI 1.744~35.195;P=0.007)是大面积脑梗塞去骨瓣减压术后预后不良的独立危险因素。结论 去骨瓣减压术治疗的大面积脑梗塞出院时预后与术前中线移位、瞳孔改变及APTT等因素相关。
Abstract:
Objective To investigate the prognostic factors of patients with massive cerebral infarction treated by decompressive craniectomy. Methods The clinical data of 80 patients with massive cerebral infarction treated by decompressive craniectomy from 2014 to 2021 were retrospectively analyzed. On discharge, GOS score was used to evaluate the prognosis, with a GOS score of 4~5 as a good prognosis and a score of 1~3 as a poor prognosis. Results On discharge, 48 patients had good prognoses and 32 patients had poor prognoses. Univariate analysis showed that location of cerebral infarction, preoperative activated partial thromboplastin time (APTT), midline shift and preoperative pupillary light reflex were correlated with the prognoses of patients with massive cerebral infarction (P<0.05). Multivariate logistic regression analysis showed that prolonged preoperative APTT (OR=1.994; 95% CI 1.406~2.828; P<0.001), midline shift ≥10 mm (OR=5.793; 95% CI 1.024~32.784; P=0.047), disappearance of pupillary light reflex before operation (OR=7.835; 95% CI 1.744~35.195; P=0.007) were independent risk factors for poor prognoses of patients with massive cerebral infarction after decompressive craniectomy. Conclusions The prognoses of patients with massive cerebral infarction treated by decompressive craniectomy is related to midline shift, pupillary light reflex and APTT.

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备注/Memo

备注/Memo:
(2022-10-16收稿,2023-05-15修回)
基金项目:国家自然医学基金(81602204)
通讯作者:欧一博,E-mail:drouyibo@163.com
更新日期/Last Update: 2022-07-31